Outcome of COVID-19 infection in multiple sclerosis patients receiving disease-modifying therapies

• Main Authors: Masoud Etemadifar, Ramin Sami, Mehri Salari, Nahad Sedaghat, Amirhossein Akhavan Sigari, Ali Aghababaei, Mohammadreza Najafi, Donya Sheibani Tehrani
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Journal of Research in Medical Sciences
• Subjects: covid-19; disease-modifying therapies; multiple sclerosis; rituximab
• Online Access: http://www.jmsjournal.net/article.asp?issn=1735-1995;year=2021;volume=26;issue=1;spage=85;epage=85;aulast=Etemadifar

Background: With the spread of COVID-19, treatment of diseases such as multiple sclerosis (MS) should be resumed with caution due to the disease-modifying therapies (DMTs) used in this subset of patients and the immunoregulatory effects of these drugs. We aim to assess the outcome of COVID-19 infection in MS patients receiving DMTs. Materials and Methods: This is a cross-sectional study involving 45 COVID-19-infected patients previously diagnosed with MS. The data regarding their MS status and the type of DMT taken by the patients were extracted from the Isfahan MS Institute registry and were summarized. Diagnosis of MS was based on the 2017 McDonald Criteria, and the diagnosis of COVID-19 was based on computed tomography scan and polymerase chain reaction of nasopharyngeal swabs. Results: Out of the 45 MS patients infected with COVID-19, 5 had unfavorable outcomes. Two patients deceased and the other three had persistent respiratory complications on the 4-week follow-up visit. Hypertension, diabetes, seizures, and rheumatoid arthritis were among the comorbidities that the patients reported. Both patients who died received rituximab as part of their MS treatment. All other patients recovered completely. Conclusion: Each different drug category may possess a distinct risk for infection, therefore until robust evidence are available, the safest drug should be utilized or the therapy should be postponed, if possible, to minimize patient risk. Disease-modifying therapy use in MS patients should be cautiously applied as their effect on COVID-19 infection prognosis is not yet studied.