Clinical Characteristics and Outcomes of Multiple Sclerosis Patients with COVID-19 in Toronto, Canada (1556)

Objective: To describe the demographic, clinical characteristics, and outcomes of people with multiple sclerosis (PwMS) with confirmed COVID-19 at the St. Michael’s Hospital (SMH) MS Clinic in Toronto, Canada. Background: There have been significant concerns regarding increased COVID-19 related morbidity and mortality among PwMS given that older age, higher disability, vascular comorbidities, and anti-CD20 therapy have been identified as risk factors associated with severe outcomes. However, emerging evidence suggests that MS and most disease-modifying therapies (DMTs) do not appear to increase the acquisition risk for COVID-19 or secondary morbidity or mortality. Due to the substantial regional variability of COVID-19 prevalence, there is a sustained need to report and evaluate COVID-19 among PwMS in different locations. Design/Methods: The SMH Clinic Registry was used to identify PwMS with polymerase chain reaction-confirmed COVID-19 between March-October, 2020. Clinical features and outcomes were obtained using registry data and retrospective chart review. Results: Among 5600 PwMS, eight patients with relapsing-remitting MS and one person with clinically isolated syndrome developed confirmed COVID-19. The mean age was 43.2 years, 88% were women, and the median EDSS score was 1.0 (range 0–5.5). All but one patient were on DMTs: interferon beta, glatiramer acetate, teriflunomide, dimethyl fumarate, and natalizumab. Two patients received corticosteroids within one month of infection. Three patients had vascular comorbidities. One patient was hospitalized and required non-invasive ventilation without admission to the intensive care unit. One patient was asymptomatic, while seven patients had mild respiratory and/or systemic symptoms. All subjects continued their DMTs and recovered without MS relapse. Conclusions: Our findings suggest that the number of PwMS followed in our clinic in Toronto, Canada, with confirmed COVID-19 was low, without strong representation by a particular DMT. Our findings highlight the regional variability of COVID-19 prevalence and the importance of contextualizing risk at a regional level to optimize the management of PwMS. Disclosure: Dr. Schulman has nothing to disclose. Ashley Jones has nothing to disclose. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Seronon. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion Pharmaceuticals. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Hohol has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. Dr. Krysko has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Normative Inc. The institution of Dr. Krysko has received research support from Biogen Idec. The institution of Dr. Krysko has received research support from National MS Society. Dr. Muccilli has nothing to disclose. Alexandra Roll has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Alexandra Roll has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Alexandra Roll has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Alexandra Roll has received personal compensation in the range of $0-$499 for serving as a Consultant for Novartis. Alexandra Roll has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Rotstein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. The institution of Dr. Rotstein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Rotstein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Rotstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Rotstein has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion . Dr. Rotstein has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Rotstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Aventis. Dr. Rotstein has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Rotstein has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. The institution of Dr. Rotstein has received research support from Multiple Sclerosis Society of Canada. The institution of Dr. Rotstein has received research support from CMSC. The institution of Dr. Rotstein has received research support from Roche Canada. Dr. Schneider has nothing to disclose. Dr. Selchen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Selchen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Roche. Dr. Selchen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Dr. Selchen has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Teva. Reza Vosoughi has nothing to disclose. Stefan Baral has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Oh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. The institution of Dr. Oh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen-Idec. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Dr. Oh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for EMD-Serono. Dr. Oh has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Oh has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen-Idec. Dr. Oh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. The institution of Dr. Oh has received research support from Biogen-Idec. The institution of Dr. Oh has received research support from EMD-Serono. The institution of Dr. Oh has received research support from Biogen-Idec.