COVID-19 in multiple sclerosis patients and risk factors for severe infection.
Multiple sclerosis (MS) patients have been considered a higher-risk population for COVID-19 due to the high prevalence of disability and disease-modifying therapy use; however, there is little data identifying clinical characteristics of MS associated with worse COVID-19 outcomes. Therefore, we conducted a multicenter prospective cohort study looking at the outcomes of 40 MS patients with confirmed COVID-19. Severity of COVID-19 infection was based on hospital course, where a mild course was defined as the patient not requiring hospital admission, moderate severity was defined as the patient requiring hospital admission to the general floor, and most severe was defined as requiring intensive care unit admission and/or death. 19/40(47.5%) had mild courses, 15/40(37.5%) had moderate courses, and 6/40(15%) had severe courses. Patients with moderate and severe courses were significantly older than those with a mild course (57[50-63] years old and 66[58.8-69.5] years old vs 48[40-51.5] years old, P = 0.0121, P = 0.0373). There was differing prevalence of progressive MS phenotype in those with more severe courses (severe:2/6[33.3%]primary-progressing and 0/6[0%]secondary-progressing, moderate:1/14[7.14%] and 5/14[35.7%] vs mild:0/19[0%] and 1/19[5.26%], P = 0.0075, 1 unknown). Significant disability was found in 1/19(5.26%) mild course-patients, but was in 9/15(60%, P = 0.00435) of moderate course-patients and 2/6(33.3%, P = 0.200) of severe course-patients. Disease-modifying therapy prevalence did not differ among courses (mild:17/19[89.5%], moderate:12/15[80%] and severe:3/6[50%], P = 0.123). MS patients with more severe COVID-19 courses tended to be older, were more likely to suffer from progressive phenotype, and had a higher degree of disability. However, disease-modifying therapy use was not different among courses.
['Chaudhry|Farhan|F|', 'Bulka|Helena|H|', 'Rathnam|Anirudha S|AS|', 'Said|Omar M|OM|', 'Lin|Jia|J|', 'Lorigan|Holly|H|', 'Bernitsas|Eva|E|', 'Rube|Jacob|J|', 'Korzeniewski|Steven J|SJ|', 'Memon|Anza B|AB|', 'Levy|Phillip D|PD|', 'Schultz|Lonni|L|', 'Javed|Adil|A|', 'Lisak|Robert|R|', 'Cerghet|Mirela|M|']
D000328:Adult D000367:Age Factors D000368:Aged D000086382:COVID-19 D015897:Comorbidity D004185:Disability Evaluation D005260:Female D006760:Hospitalization D006801:Humans D007362:Intensive Care Units D008297:Male D008875:Middle Aged D009103:Multiple Sclerosis D058873:Pandemics D010641:Phenotype D015995:Prevalence D011446:Prospective Studies D012307:Risk Factors D000086402:SARS-CoV-2 D014481:United States
COVID-19 Multiple sclerosis Disease-modifying therapy Coronavirus SARS-CoV-2019