Risk and outcomes of COVID‐19 in patients with multiple sclerosis
Irene Moreno‐Torres, Virginia Meca‐Lallana, Lucienne Costa‐Frossard, Celia Oreja‐Guevara, Clara Aguirre, Elda María Alba Suárez, Mayra Gómez‐Moreno, Laura Borrega Canelo, Julia Sabín Muñoz, Yolanda Aladro, Alba Cárcamo-Fonfría, Elena García, Juan Pablo Cuello, Enric Monreal, Susana Sainz de la Maza, Fernando Pérez Parra, Francisco Valenzuela Rojas, Carlos López de Silanes de Miguel, Ignacio Casanova, María Luisa Martínez Ginés, Rosario Blasco, Aida Orviz García, Luisa María Villar‐Guimerans, Guillermo Fernández‐Dono, V́ıctor Elvira, Carmen Santiuste, Mercedes Espiño, José Manuel García‐Domínguez
Abstract
BACKGROUND AND PURPOSE: Limited information is available on incidence and outcomes of COVID-19 in patients with multiple sclerosis (MS). This study investigated the risks of SARS-CoV-2 infection and COVID-19-related outcomes in patients with MS, and compared these with the general population. METHODS: A regional registry was created to collect data on incidence, hospitalization rates, intensive care unit admission, and death in patients with MS and COVID-19. National government outcomes and seroprevalence data were used for comparison. The study was conducted at 14 specialist MS treatment centers in Madrid, Spain, between February and May 2020. RESULTS: Two-hundred nineteen patients were included in the registry, 51 of whom were hospitalized with COVID-19. The mean age ± standard deviation was 45.3 ± 12.4 years, and the mean duration of MS was 11.9 ± 8.9 years. The infection incidence rate was lower in patients with MS than the general population (adjusted incidence rate ratio = 0.78, 95% confidence interval [CI] = 0.70-0.80), but hospitalization rates were higher (relative risk = 5.03, 95% CI = 3.76-6.62). Disease severity was generally low, with only one admission to an intensive care unit and five deaths. Males with MS had higher incidence rates and risk of hospitalization than females. No association was found between the use of any disease-modifying treatment and hospitalization risk. CONCLUSIONS: Patients with MS do not appear to have greater risks of SARS-CoV-2 infection or severe COVID-19 outcomes compared with the general population. The decision to start or continue disease-modifying treatment should be based on a careful risk-benefit assessment.