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