Farinaz Safavi1, Bardia Nourbakhsh2, Amir Reza Azimi3. 1. National Institutes of Neurological Disorders and Stroke, NIH, MD, USA. 2. Department of Neurology, Johns Hopkins University, MD, USA. 3. MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences,Tehran, Iran.
Abstract
Objective: To determine whether the course of COVID-19 is more severe in patients with MS and if MS disease-modifying treatments (DMTs) affect the risk of contracting the disease. Methods: In a cross-sectional survey, data were collected by sending a questionnaire to 2000 patients with a demyelinating disease through an online portal system. Collected data included the current MS DMT and patient-reported disability level, history of recent sick contact, recent fever, respiratory symptoms, diagnosis with COVID-19 and the disposition after the diagnosis. We defined a COVID-19-suspect group as patients having fever and cough or fever and shortness of breath, or a presumptive diagnosis based on suggestive chest computed tomography. We calculated the proportion of COVID-19-suspect patients and compared their demographics, clinical characteristics, and DMT categories with the rest of survey-responders, using univariable and multivariable models. Results: Out of 712 patients, 34 (4.8%) fulfilled our criteria for being in the COVID-19-suspect group. Only two patients required hospitalization. No patient required intensive care. In a multivariable model, disease duration (p-value=0.017), DMT category (p-value=0.030) and history of sick contact (p-values<0.001) were associated with the risk of being in the COVID-19-suspect group. Patients on B-cell depleting antibodies had 3.6 times higher risk of being in the COVID-19-suspect group as compared to patients on none-lymphocyte-depleting and non-cell trafficking inhibitor DMTs (95%CI: 1.45, 8.68, p-value=0.005). Conclusions: The course of infection in MS patients suspected of having COVID-19 was mild to moderate, and all patients had a full recovery. B-cell depleting antibodies may increase the susceptibility to contracting COVID-19.
Objective: To determine whether the course of COVID-19 is more severe in patients with MS and if MS disease-modifying treatments (DMTs) affect the risk of contracting the disease. Methods: In a cross-sectional survey, data were collected by sending a questionnaire to 2000 patients with a demyelinating disease through an online portal system. Collected data included the current MS DMT and patient-reported disability level, history of recent sick contact, recent fever, respiratory symptoms, diagnosis with COVID-19 and the disposition after the diagnosis. We defined a COVID-19-suspect group as patients having fever and cough or fever and shortness of breath, or a presumptive diagnosis based on suggestive chest computed tomography. We calculated the proportion of COVID-19-suspect patients and compared their demographics, clinical characteristics, and DMT categories with the rest of survey-responders, using univariable and multivariable models. Results: Out of 712 patients, 34 (4.8%) fulfilled our criteria for being in the COVID-19-suspect group. Only two patients required hospitalization. No patient required intensive care. In a multivariable model, disease duration (p-value=0.017), DMT category (p-value=0.030) and history of sick contact (p-values<0.001) were associated with the risk of being in the COVID-19-suspect group. Patients on B-cell depleting antibodies had 3.6 times higher risk of being in the COVID-19-suspect group as compared to patients on none-lymphocyte-depleting and non-cell trafficking inhibitor DMTs (95%CI: 1.45, 8.68, p-value=0.005). Conclusions: The course of infection in MS patients suspected of having COVID-19 was mild to moderate, and all patients had a full recovery. B-cell depleting antibodies may increase the susceptibility to contracting COVID-19.
Authors: Richard E Nelson; Yan Xie; Scott L DuVall; Jorie Butler; Aaron W C Kamauu; Kristin Knippenberg; Markus Schuerch; Nadia Foskett; Joanne LaFleur Journal: Int J MS Care Date: 2015 Sep-Oct
Authors: Jeffrey A Cohen; Frederik Barkhof; Giancarlo Comi; Hans-Peter Hartung; Bhupendra O Khatri; Xavier Montalban; Jean Pelletier; Ruggero Capra; Paolo Gallo; Guillermo Izquierdo; Klaus Tiel-Wilck; Ana de Vera; James Jin; Tracy Stites; Stacy Wu; Shreeram Aradhye; Ludwig Kappos Journal: N Engl J Med Date: 2010-01-20 Impact factor: 91.245