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Treatment with interferon can reduce the risk of COVID-19 in patients with multiple sclerosis (MS), while treatment with anti-CD20 therapies can increase this risk. from April 17th to 22nd.
Researchers in the current study previously presented data collected as of March 2020 from patients with MS with suspected or confirmed COVID-19. As routine serological tests increased, data was also collected for asymptomatic patients with MS and COVID-19.
The current retrospective multicenter observational study included 902 patients with MS, including 298 (33%) with confirmed COVID-19 and 604 (67%) with suspected COVID-19. Approximately 4% (n = 37) of the patients were asymptomatic, which was classified as a stage 1 disease. The other 3 levels that define COVID-19 in this study included level 2, represented by the presence of symptoms with no signs of pneumonia; Stage 3, including radiologically defined pneumonia or hospitalization; and Stage 4, defined as ICU admission or death.
A total of 8 out of 95 patients who received anti-CD20 therapies entered the intensive care unit or died. Approximately 5% (n = 37) of patients with MS who received treatment other than anti-CD20 therapies and interferon also either entered the intensive care unit or died. Of the 37 asymptomatic patients, 7 (8.3%) received treatment with interferon, 1 (1.1%) with anti-CD20 and 29 (4%) with other drugs.
In the multivariable analysis, independent risk factors for severe COVID-19 included age (odds ratio) [OR]1.05; P <0.001), expanded disability status scale (OR, 1.13; P = 0.02) and male gender (OR, 1.44; P = 0.057). Treatment with anti-CD20, including ocrelizumab or rituximab, was also associated with an increased risk of severe COVID-19 (OR, 1.99; P = 0.035). However, treatment with interferon was associated with a reduced risk of severe COVID-19 (OR, 0.48; P = 0.05) compared to treatment with dimethyl fumarate, a disease-modifying reference therapy.
The researchers concluded: “Data on asymptomatic patients accumulates rapidly and provides useful information about this specific subset of [patients]. ”
Sormani MP, Rossi ND, Schiavetti I, et al. Various disease-modifying therapies can increase or decrease the severity of Covid-19 in multiple sclerosis. Virtual annual conference AAN 2021; 17.-22. April 2021. Abstract S28.002.