RT Journal Article SR Electronic T1 SARS-CoV-2 Infection in Multiple Sclerosis JF Neurology - Neuroimmunology Neuroinflammation JO Neurol Neuroimmunol Neuroinflamm FD Lippincott Williams & Wilkins SP e1024 DO 10.1212/NXI.0000000000001024 VO 8 IS 5 A1 Arrambide, Georgina A1 Llaneza-González, Miguel Ángel A1 Costa-Frossard França, Lucienne A1 Meca-Lallana, Virginia A1 Díaz, Eva Fernández- A1 Moreno-Torres, Irene A1 García-Domínguez, Jose Manuel A1 Ortega-Suero, Gloria A1 Ayuso-Peralta, Lucía A1 Gómez-Moreno, Mayra A1 Sotoca-Fernández, Javier J. A1 Caminero-Rodríguez, Ana Belén A1 Rodríguez de Antonio, Luis A. A1 Corujo-Suárez, Marcial A1 Otano-Martínez, María A. A1 Pérez-Miralles, Francisco Carlos A1 Reyes-Garrido, Virginia A1 Ayuso-Blanco, Teresa A1 Balseiro-Gómez, José Jesús A1 Muñoz-Pasadas, Mercedes A1 Pérez-Molina, Inmaculada A1 Arnal-García, Carmen A1 Domingo-Santos, Ángela A1 Guijarro-Castro, Cristina A1 Íñiguez-Martínez, Cristina A1 Téllez Lara, Nieves A1 Castellanos-Pinedo, Fernando A1 Castillo-Triviño, Tamara A1 Cerdán-Santacruz, Debora María A1 Pérez-Sempere, Ángel A1 Torres, Berta Sebastián A1 Álvarez de Arcaya, Amaya A1 Costa-Arpín, Eva A1 Durán-Ferreras, Eduardo A1 Fragoso-Martínez, Marta A1 González-Platas, Montserrat A1 Landete Pascual, Lamberto A1 Millán-Pascual, Jorge A1 Oreja-Guevara, Celia A1 Meca-Lallana, José E. YR 2021 UL http://nn.neurology.org/content/8/5/e1024.abstract AB Objective To understand COVID-19 characteristics in people with multiple sclerosis (MS) and identify high-risk individuals due to their immunocompromised state resulting from the use of disease-modifying treatments.Methods Retrospective and multicenter registry in patients with MS with suspected or confirmed COVID-19 diagnosis and available disease course (mild = ambulatory; severe = hospitalization; and critical = intensive care unit/death). Cases were analyzed for associations between MS characteristics and COVID-19 course and for identifying risk factors for a fatal outcome.Results Of the 326 patients analyzed, 120 were cases confirmed by real-time PCR, 34 by a serologic test, and 205 were suspected. Sixty-nine patients (21.3%) developed severe infection, 10 (3%) critical, and 7 (2.1%) died. Ambulatory patients were higher in relapsing MS forms, treated with injectables and oral first-line agents, whereas more severe cases were observed in patients on pulsed immunosuppressors and critical cases among patients with no therapy. Severe and critical infections were more likely to affect older males with comorbidities, with progressive MS forms, a longer disease course, and higher disability. Fifteen of 33 patients treated with rituximab were hospitalized. Four deceased patients have progressive MS, 5 were not receiving MS therapy, and 2 were treated (natalizumab and rituximab). Multivariate analysis showed age (OR 1.09, 95% CI, 1.04–1.17) as the only independent risk factor for a fatal outcome.Conclusions This study has not demonstrated the presumed critical role of MS therapy in the course of COVID-19 but evidenced that people with MS with advanced age and disease, in progressive course, and those who are more disabled have a higher probability of severe and even fatal disease.ANOVA=analysis of variance; CI=confidence interval; DMT=disease-modifying treatment; EDSS=Expanded Disability Status Scale; ICU=intensive care unit; IQR=interquartile range; IVMP=IV pulses of methylprednisolone; MS=multiple sclerosis; OR=odds ratio; RT=real time; SARS-CoV-2=severe acute respiratory syndrome coronavirus 2