Propriospinal myoclonus associated to Sars-Cov-2 respiratory infection

Background and aims: Patients with multiple sclerosis (MS) may be at higher risk of infection and complications from the Coronavirus disease 19 (COVID-19), in part due to the use of disease-modifying treatment (DMTs). The objective of this study was to determine the frequency and severity of COVID-19 in our MS population, and the potential risk factors in contracting this viral infection. Methods: This is a retrospective single-centre study of all MS patients who attended our neuro-immunology outpatient clinic from May to December 2020. Clinical features, treatments, and outcomes were recorded. COVID- 19 infection was identified by means of a positive outcome on PCR testing, serology, or CT imaging. Results: Of 275 patients studied (mean age 43.4 years, 67.6% women), 28 patients (10.2%) had a confirmed COVID-19 infection. Mean age of this group was 36.4 years, of which 18 (64.3%) were women. 26 had relapsingremitting MS, one had primary-progressive MS, and one secondary-progressive MS. COVID-19 risk-factors included hypertension (1), a Body Mass Index (BMI) >30 (2) and cancer (1). Six patients were infected during the 1st wave of the epidemic (February-August 2020), in comparison to 22 during the second wave (September- December 2020). Aside from one patient, all were on MS treatment: Teriflunomide (2), Dimethyl fumarate (9), Fingolimod (3), Natalizumab (5), Ocrelizumab (4), Alemtuzumab (1), Cladribine (2), Siponimod (1). One patient needed to be hospitalised. There was no mortality. Conclusion: Our findings show a good overall outcome for those MS patients infected with COVID-19, with no apparent difference in disease-modifying treatment and COVID-19 disease course.