Characteristics of COVID-19 in patients with multiple sclerosis

Abstract

Background: Regarding the high prevalence of multiple sclerosis (MS) and COVID-19 in Iran, a multicenter study of COVID-19 in Iranian MS patients with is carried out to address the concerns of this population. Methods: Data on MS patients with COVID-19 from nine provinces of Iran were entered in a web-based registry system, between July 2020 and March 2021. Among the COVID-19 symptoms, dyspnea, altered mental status, or those resulting in hospital admission were considered severe. Results: A total of 397 eligible patients were identified. In addition, 310 (78) were female. The mean age was 36.5 9.5. 294 (74) patients had relapsing- remitting form. Also, four patients (1) expired due to COVID-19 infection. The mean duration of admission in hospitalized patients was 9 (+/- 5.3) days. MRI was performed on 111 (28) patients after developing COVID-19. MRI changes were observed in 27 (24) of these cases. MS drug was changed in 26 (6) patients. Steroid use in the past three months (OR: 2.43, 95 CI: 1.003-5.88) (p value: 0.049) and antiCD20s (OR: 4.03, 95 CI: 2.41-6.68) (p value < 0.001) showed significant association with severe COVID-19 symptoms. Conclusion: The death rate of COVID-19 among MS patients (1) is lower than the overall death rate of the pandemic in Iran (3). Those who received steroid in the past three months may be at increased risk of more severe forms of COVID-19. There are still doubts about the effect of anti CD20s on COVID-19 severity.