Neurological

COVID-19 incidence higher in patients with MS than in the general population

The incidence of COVID-19 in patients with multiple sclerosis (MS) was higher than in the general population, but most patients with this chronic inflammatory disorder did not have to be hospitalized. They generally had good results, despite having an increased number of comorbidities and using disease-modifying therapies (DMTs). This was the result of the study results published in Neurology: Neuroimmunology & Neuroinflammation.

This cross-sectional, mixed-method study included a survey of MS patients in the MS department of the Barcelona Hospital Clinic. The survey was a self-administered questionnaire that was emailed to 586 MS patients on May 21, 2020. Study investigators conducted a telephone interview and reviewed the participants’ electronic medical records by June 18, 2020.

The study’s investigators looked at the cumulative incidence of confirmed COVID-19 and all cases of COVID-19 that were either confirmed or suspected. They compared the cumulative incidence of confirmed cases, as well as all COVID-19 cases since the pandemic began, with estimates of the total population for the Spanish city.

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Approximately 69.5% of the participants (n = 407) who were emailed the questionnaire completed the survey. The average age of the respondents was 48 years. Up to 84% of the patients had a relapsing disease. Almost half of the patients (45%) had at least 1 comorbidity, and the majority of the patients (74.7%) received DMT.

The confirmed COVID-19 and suspected COVID-19 rates were 1.2% and 11.3%, respectively. While the cumulative incidence of confirmed COVID-19 was similar to incidents reported in the general population (1.27%) [95% CI, 0.18-2.36] vs 1.32% [95% CI, 1.30-1.34]each) it was 1.74 times higher when all cases of confirmed and suspected COVID-19 were included (11.65%) [95% CI, 9.31-15.75] vs 6.69% [95% CI, 6.65-6.73], respectively; P <0.001).

Approximately 11.7% of the patients were hospitalized, including 5 patients who had recovered well and 1 patient who died. Patients admitted to the hospital were more likely to be male (83% versus 26.6%; P = 0.012), more likely to have diabetes (33.3% versus 0%; P = 0.012), and more likely to have a progressive form of MS ( 50%) vs 11%; P = 0.042) compared to patients with a mild course of the disease.

Male sex was a significant risk factor associated with hospitalization when included in the multivariate logistic regression model (odds ratio, 13.08; 95% CI, 1.39-122.85; P = 0.024). No association was found between the use of DMT and the risk of infection or any outcome.

Limitations of this study included reliance on self-reported data and the inclusion of only patients from a single center in Barcelona.

The study’s investigators found that their results “need to be confirmed by large population-based studies or larger registration studies”.

Disclosure: Several authors of the study have stated that they are part of the pharmaceutical industry. For a full list of the authors’ information, see the original reference.

reference

Sepúlveda M., Llufriu S., Martínez-Hernández E. et al. Incidence and Impact of COVID-19 in MS: A Survey by an MS Department in Barcelona. Neurol Neuroimmunol Neuroinflamm. 2021; 8 (2): e954. doi: 10.1212 / NXI.0000000000000954

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