Agata Czarnowska1, Waldemar Brola2, Olga Zajkowska3, Stanisław Rusek4, Monika Adamczyk-Sowa5, Katarzyna Kubicka-Bączyk5, Alicja Kalinowska-Łyszczarz6, Karolina Kania7, Agnieszka Słowik8, Marcin Wnuk8, Monika Marona8, Aleksandra Podlecka-Piętowska9, Monika Nojszewska9, Beata Zakrzewska-Pniewska9, Elżbieta Jasińska10, Katarzyna Gołuch11, Beata Lech12, Magdalena Noga12, Adam Perenc12, Małgorzata Popiel12, Anetta Lasek-Bal13, Przemysław Puz13, Katarzyna Maciejowska13, Marta Kucharska-Lipowska14, Michał Lipowski15, Katarzyna Kapica-Topczewska16, Monika Chorąży16, Joanna Tarasiuk16, Jan Kochanowicz16, Joanna Kulikowska16, Sławomir Wawrzyniak17, Anna Niezgodzińska-Maciejek17, Anna Pokryszko-Dragan18, Ewa Gruszka18, Sławomir Budrewicz18, Marta Białek19, Iwona Kurkowska-Jastrzębska20, Katarzyna Kurowska20, Adam Stępień21, Agata Włodek22, Violetta Ptasznik23, Małgorzata Pawełczyk24, Piotr Sobolewski25, Henryka Lejmel26, Katarzyna Strzalińska27, Maciej Maciejowski28, Andrzej Tutaj29, Jacek Zwiernik30, Anna Litwin29, Bożena Lewańczyk31, Izabela Paprocka31, Beata Zwiernik32, Aleksandra Pawlos33, Andrzej Borysowicz34, Anna Narożnik34, Anna Michałowska29, Krzysztof Nosek33, Małgorzata Fudala35, Marta Milewska-Jędrzejczak36, Alina Kułakowska16, Halina Bartosik-Psujek37. 1. Medical University of Białystok, Poland. agata.czarnowska@umb.edu.pl. 2. Collegium Medicum, Jan Kochanowski University, Kielce, Poland. 3. Faculty of Economic Sciences, University of Warsaw, Poland. 4. Department of Neurology, Specialist Hospital Ludwika Rydygiera in Krakow, Poland. 5. Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland. 6. Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poland. 7. Department of Neurology, Poznan University of Medical Sciences, Poland. 8. Department of Neurology, Jagiellonian University Medical College, Krakow, Poland. 9. Department of Neurology, Medical University of Warsaw, Poland. 10. Collegium Medicum UJK, and Clinical Center, RESMEDICA, Kielce, Poland. 11. Clinical Center, RESMEDICA, Kielce, Poland. 12. Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland. 13. Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland. 14. Department of Neurology, Specialist Hospital in Końskie, Poland. 15. Department of Urology, Specialist Hospital in Końskie, Poland. 16. Medical University of Białystok, Poland. 17. Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, Bydgoszcz, Poland. 18. Department of Neurology, Wroclaw Medical University, Wroclaw, Poland. 19. Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Poland. 20. 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland. 21. Department of Neurology, Military Institute of Medicine, Warsaw, Poland. 22. Department of Neurology, Masovian Voivodeship Hospital in Siedlce, Poland. 23. Department of Neurology, Specialist Hospital in Pila, Poland. 24. Department of Neurology and Stroke, Medical University of Lodz, Poland. 25. Department of Neurology and Stroke Unit in Sandomierz, Collegium Medicum, Jan Kochanowski University in Kielce. 26. Department of Neurology, The Regional Hospital in Suwalki, Poland. 27. Department of Neurology, The Regional Hospital in Łomża, Poland. 28. KMK Clinical, MS Center, Katowice, Poland. 29. Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland. 30. Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland; Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland. 31. Neurology Ward, Provincial Integrated Hospital, Elbląg, Poland. 32. Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland; Clinic of Neurology, University of Warmia and Mazury, Olsztyn, Poland. 33. Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland. 34. Department of Neurology, Specialist Hospital Dr Tytus Chałubiński Radom, Poland. 35. Department of Neurology, Regional Hospital in Skarżysko-Kamienna, Poland. 36. Department of Neurology and Ischemic Strokes, Medical University of Lodz, Poland. 37. Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Poland.
Abstract
INTRODUCTION: The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited. MATERIALS AND METHODS: This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health. RESULTS: There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used. CONCLUSIONS AND CLINICAL IMPLICATIONS: Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs.
INTRODUCTION: The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited. MATERIALS AND METHODS: This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health. RESULTS: There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used. CONCLUSIONS AND CLINICAL IMPLICATIONS: Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs.
Authors: Bruce Ac Cree; Krzysztof W Selmaj; Lawrence Steinman; Giancarlo Comi; Amit Bar-Or; Douglas L Arnold; Hans-Peter Hartung; Xavier Montalbán; Eva K Havrdová; James K Sheffield; Neil Minton; Chun-Yen Cheng; Diego Silva; Ludwig Kappos; Jeffrey A Cohen Journal: Mult Scler Date: 2022-06-28 Impact factor: 5.855
Authors: Ewa Krzystanek; Agata Jurczak; Kinga Kocur; Jakub Jurkiewicz; Aleksandra Kaczmarczyk Journal: Int J Environ Res Public Health Date: 2022-03-12 Impact factor: 3.390