COVID-19 infection in patients with multiple sclerosis in Castilla La-Mancha (Spain): Multicenter study

Background and aims: The emergence of the new SARSCoV- 2 coronavirus and the devastating pandemic derived from COVID-19 have hit Castilla La-Mancha (CLM) hard. Neurologists have had to make complex management decisions, particularly in patients treated with immunosuppressants, including those with multiple sclerosis (MS) on disease-modifying therapy (MST). However, it is unknown whether MS is associated with increased risk of infection or severity. Our objective is to describe the impact of COVID-19 on MS patients in CLM. Methods: Observational, descriptive and retrospective, multicenter study in patients with MS and COVID-19 infection at the HG La Mancha Centro (Alcazar de San Juan) and CHU de Albacete between February and May 2020. Results: 46 patients with MS and COVID-19 infection were recruited. The mean age was 42.2 years, the RRMS was 37% and the mean EDSS was 2.4;30 with confirmation of infection, by PCR (33.3%), serology (26%) or both (34.7%);37 (80.4%) were being treated with TME at the time of infection, remaining in 56.8% of them. Regarding the clinical manifestations, 38 (82.6%) had fever, 33 (71.7%) had respiratory symptoms and 31 (67.4%) had neurological;six (13%) patients had concomitant outbreaks or pseudo-outbreaks, eight (17.4%) required hospital admission, and 1 patient died of the infection. Conclusion: Our experience leads us to think that patients with MS present an incidence and evolution of COVID-19 infection similar to other series of MS patients and healthy population with the same characteristics. The type of MSD and its duration do not appear to worsen the course of the infection.