COVID-19 outcomes in MS: Observational study of early experience from NYU Multiple Sclerosis Comprehensive Care Center

• Published in: Neurology : neuroimmunology & neuroinflammation 2020-09, Vol.7 (5), p.e835-e835
• Main Authors: Parrotta, Erica, Kister, Ilya, Charvet, Leigh, Sammarco, Carrie, Saha, Valerie, Charlson, Robert Erik, Howard, Jonathan, Gutman, Josef Maxwell, Gottesman, Malcolm, Abou-Fayssal, Nada, Wolintz, Robyn, Keilson, Marshall, Fernandez-Carbonell, Cristina, Krupp, Lauren B., Zhovtis Ryerson, Lana
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antiviral Agents - adverse effects; Antiviral Agents - therapeutic use; Betacoronavirus - drug effects; Coronavirus Infections - complications; Coronavirus Infections - drug therapy; COVID-19; COVID-19 Drug Treatment; Female; Hospitalization; Humans; Hydroxychloroquine - adverse effects; Hydroxychloroquine - therapeutic use; Male; Middle Aged; Multiple Sclerosis - complications; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - drug therapy; Risk Factors; SARS-CoV-2; Time Factors; Young Adult
• ISSN: 2332-7812; 2332-7812
• DOI: 10.1212/NXI.0000000000000835

To report outcomes on patients with multiple sclerosis (MS) and related disorders with coronavirus disease 2019 (COVID-19) illness. From March 16 to April 30, 2020, patients with MS or related disorders at NYU Langone MS Comprehensive Care Center were identified with laboratory-confirmed or suspected COVID-19. The diagnosis was established using a standardized questionnaire or by review of in-patient hospital records. We identified 76 patients (55 with relapsing MS, of which 9 had pediatric onset; 17 with progressive MS; and 4 with related disorders). Thirty-seven underwent PCR testing and were confirmed positive. Of the entire group, 64 (84%) patients were on disease-modifying therapy (DMT) including anti-CD20 therapies (n = 34, 44.7%) and sphingosine-1-phosphate receptor modulators (n = 10, 13.5%). The most common COVID-19 symptoms were fever and cough, but 21.1% of patients had neurologic symptom recrudescence preceding or coinciding with the infection. A total of 18 (23.7%) were hospitalized; 8 (10.5%) had COVID-19 critical illness or related death. Features more common among those hospitalized or with critical illness or death were older age, presence of comorbidities, progressive disease, and a nonambulatory status. No DMT class was associated with an increased risk of hospitalization or fatal outcome. Most patients with MS with COVID-19 do not require hospitalization despite being on DMTs. Factors associated with critical illness were similar to the general at-risk patient population. DMT use did not emerge as a predictor of poor COVID-19 outcome in this preliminary sample.