Prognostic factors related to the risk of COVID-19 infection in MS patients

Background and aims: It is still debated whether Multiple Sclerosis (MS) patients are at high-risk of COVID-19 because of their life style, disease-or treatments-associated immune alterations. We compared features of MS patients with COVID-19 infection (MS-COVID) to those of residency-, age-, sex-and treatment-matched MS controls (MS-NCOVID). Moreover, the severity of COVID-19 infection was assessed in MS-COVID patients and their cohabitants. Methods: So far, we have enrolled 25 MS-COVID and 104 MS-NCOVID patients. Neurological examination, premorbid laboratory tests, anthropometric variables (height, weight and BMI), life-style habits (smoke, alcohol intake, diet), working-activity and living conditions (number of cohabitants, school-aged children) were assessed. COVID-19 severity was evaluated in terms of fever (magnitude, duration), radiological pneumonia and typical symptoms. Results: Clinical and anthropometric features, life-style habits and living conditions were similar between MS-COVID and MS-NCOVID patients. However, they differed in terms of working activity, with lower rate of unemployment (7.1% vs 23.4%) and higher rate of teamworking (61.5% vs 26.5%) in the MS-COVID group (p<0.01). Furthermore, MS-COVID patients had lower premorbid vitamin D levels (31 vs 40ng/ml p=0.048) and higher neutrophils count (3,803 vs 3,182 cells/ul, p=0.046). Disease course was similar between MS-COVID patients and their cohabitants with fever, ageusia and anosmia being the most common symptoms. Fever and radiologic signs of pneumonia were also comparable. Conclusion: Working-activity, lower vitamin D levels and higher neutrophil count seem to be associated with the risk of COVID-19 infection in MS patients. The burden of COVID-19 disease was comparable between MS patients and their cohabitants.