SARS-CoV-2 infection and seroprevalence in patients with multiple sclerosis

R Piñar Morales, M A Ramírez Rivas, F J Barrero Hernández, R Piñar Morales, M A Ramírez Rivas, F J Barrero Hernández

Abstract

Introduction: The effect of SARS-CoV-2 infection in patients with multiple sclerosis (MS) and the influence of disease-modifying therapies (DMT) for MS on COVID-19 are unknown. To date, patients with MS have not been shown to present greater risk of COVID-19 or more severe progression of the disease.

Methods: We performed a descriptive study of patients with MS presenting SARS-CoV-2 infection diagnosed with PCR. We analysed demographic, clinical, laboratory, and treatment variables in our sample. Presence of antibodies against the virus was also determined.

Results: Relapsing-remitting MS (RRMS) was the most frequent form of MS in our sample. Prognosis was unfavourable in 10.2% of patients, and was associated with older age and higher scores on the Expanded Disability Status Scale (EDSS). Seroprevalence of antibodies against SARS-CoV-2 was 83.3% in our sample. Development of antibodies was not associated with DMT, lymphocytopaenia, or any of the other variables analysed.

Conclusions: The incidence of COVID-19 was slightly higher in our sample than in the general population in our province. Unfavourable prognosis was associated with older age and higher EDSS scores. DMT and lymphocytopaenia did not influence the clinical course of COVID-19. Seroprevalence of antibodies against the virus in our sample was similar to that reported for the general population with positive PCR results for the virus; the influence of specific DMTs could not be determined.

Keywords: COVID-19; Covid-19; Disease-modifying therapy; Esclerosis múltiple; Linfopenia; Lymphocytopaenia; Multiple sclerosis; SARS-CoV-2; Seroprevalence; Seroprevalencia; Tratamiento modificador de la enfermedad.

Copyright © 2021 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

Figures

Figure 1
Figure 1
Distribution of disease-modifying treatments in patients with multiple sclerosis and SARS-CoV-2 infection.

References

    1. Centro de Coordinación de Alertas y Emergencias Sanitarias. Ministerio de Sanidad [Accessed 24 February 2021]. Available from: .
    1. Luna G., Alping P., Burman J., Fink K., Fogdell-Hahn A., Gunnarsson M., et al. Infection risks among patients with multiple sclerosis treated with fingolimod, natalizumab, rituximab, and injectable therapies. JAMA Neurol. 2020;77:184–191. doi: 10.1001/jamaneurol.2019.3365.
    1. Du R.H., Liang L.R., Yang C.Q., Wang W., Cao T.Z., Li M., et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020;55 doi: 10.1183/13993003.00524-2020. Erratum in: Eur Respir J. 2020 Sep 24; 56(3): PMID: 32269088; PMCID: PMC7144257.
    1. Baker D., Amor S., Kang A.S., Schmierer K., Giovannoni G. The underpinning biology relating to multiple sclerosis disease modifying treatments during the COVID-19 pandemic. Mult Scler Relat Disord. 2020;43 doi: 10.1016/j.msard.2020.102174.
    1. Möhn N., Konen F.F., Pul R., Kleinschnitz C., Prüss H., Witte T., et al. Experience in multiple sclerosis patients with COVID-19 and disease-modifying therapies: a review of 873 published cases. J Clin Med. 2020;9:4067. doi: 10.3390/jcm9124067.
    1. Giovannoni G. Anti-CD20 immunosuppressive disease-modifying therapies and COVID-19. Mult Scler Relat Disord. 2020;41 doi: 10.1016/j.msard.2020.102135.
    1. Zabalza A., Cárdenas-Robledo S., Tagliani P., Arrambide G., Otero-Romero S., Carbonell-Mirabent P., et al. COVID-19 in multiple sclerosis patients: susceptibility, severity risk factors and serological response. Eur J Neurol. 2020 doi: 10.1111/ene.14690. In press.
    1. Parrotta E., Kister I., Charvet L., Sammarco C., Saha V., Charlson R.E., et al. COVID-19 outcomes in MS: observational study of early experience from NYU Multiple Sclerosis Comprehensive Care Center. Neurol Neuroimmunol Neuroinflamm. 2020;7:e835. doi: 10.1212/NXI.0000000000000835.
    1. Izcovich A., Ragusa M.A., Tortosa F., Lavena Marzio M.A., Agnoletti C., Bengolea A., et al. Prognostic factors for severity and mortality in patients infected with COVID-19: a systematic review. PLoS One. 2020;15 doi: 10.1371/journal.pone.0241955.
    1. Loonstra F.C., Hoitsma E., Van Kempen Z.L., Killestein J., Mostert J.P. COVID-19 in multiple sclerosis: the Dutch experience. Mult Scler. 2020;26:1256–1260. doi: 10.1177/1352458520942198.
    1. Salter A., Fox R.J., Newsome S.D., Halper J., Li D.K.B., Kanellis P., et al. Outcomes and Risk Factors Associated With SARS-CoV-2 Infection in a North American Registry of Patients With Multiple Sclerosis. JAMA Neurol. 2021 doi: 10.1001/jamaneurol.2021.0688. Epub ahead of print. Mar 19.
    1. Louapre C., Collongues N., Stankoff B., Giannesini C., Papeix C., Bensa C., et al. Clinical characteristics and outcomes in patients with coronavirus disease 2019 and multiple sclerosis. JAMA Neurol. 2020;77(9):1079–1088. doi: 10.1001/jamaneurol.2020.2581.
    1. Consejería de Salud y Familias en colaboración con elInstituto de Estadística y Cartografía de Andalucía. Juntade Andalucía. Informe COVID-19 en Andalucía [Accessed 24 February 2021]. Available from: .
    1. Ciampi E., Uribe-San-Martín R., Soler B., Fernández R., García P., Navarrete-Asenjo C., et al. COVID-19 in MS and NMOSD: a multicentric online national survey in Chile. Mult Scler Relat Disord. 2020;45 doi: 10.1016/j.msard.2020.102392.
    1. Montero-Escribano P., Matías-Guiu J., Gómez-Iglesias P., Porta-Etessam J., Pytel V., Matias-Guiu J.A. Anti-CD20 and COVID-19 in multiple sclerosis and related disorders: a case series of 60 patients from Madrid, Spain. Mult Scler Relat Disord. 2020;42 doi: 10.1016/j.msard.2020.102185.
    1. Dalla Costa G., Leocani L., Montalban X., Guerrero A.I., Sørensen P.S., Magyari M., et al. RADAR-CNS consortium. Real-time assessment of COVID-19 prevalence among multiple sclerosis patients: a multicenter European study. Neurol Sci. 2020;41:1647–1650. doi: 10.1007/s10072-020-04519-x.
    1. Ciccarelli O., Cohen J.A., Thompson A. Response of the multiple sclerosis community to COVID-19. Mult Scler. 2020;26:1134–1136. doi: 10.1177/1352458520948748.
    1. Sormani M.P., Italian Study Group on COVID-19 infection in multiple sclerosis An Italian programme for COVID-19 infection in multiple sclerosis. Lancet Neurol. 2020;19:481–482. doi: 10.1016/S1474-4422(20)30147-2.
    1. Rostami Mansoor S., Ghasemi-Kasman M. Impact of disease-modifying drugs on the severity of COVID-19 infection in multiple sclerosis patients. J Med Virol. 2021;93:1314–1319. doi: 10.1002/jmv.26593.
    1. Cuadrado A., Pajares M., Benito C., Jiménez-Villegas J., Escoll M., Fernández-Ginés R., et al. Can activation of NRF2 Be a strategy against COVID-19? Trends Pharmacol Sci. 2020;41:598–610. doi: 10.1016/j.tips.2020.07.003.
    1. Timpani C.A., Rybalka E. Calming the (Cytokine) storm: dimethyl fumarate as a therapeutic candidate for COVID-19. Pharmaceuticals (Basel). 2020;14:15. doi: 10.3390/ph14010015.
    1. Tasat D.R., Yakisich J.S. Rationale for the use of sphingosine analogues in COVID-19 patients. Clin Med (Lond). 2021;21:e84–e87. doi: 10.7861/clinmed.2020-0309.
    1. Capasso N., Palladino R., Montella E., Pennino F., Lanzillo R., Carotenuto A., et al. Prevalence of SARS-CoV-2 antibodies in multiple sclerosis: the hidden part of the iceberg. J Clin Med. 2020;9:4066. doi: 10.3390/jcm9124066.
    1. Pollán M., Pérez-Gómez B., Pastor-Barriuso R., Oteo J., Hernán M.A., Pérez-Olmeda M., et al. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study. Lancet. 2020;396:535–544. doi: 10.1016/S0140-6736(20)31483-5.

Source: PubMed

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