SARS-CoV-2 infection and multiple sclerosis: Experience in Albacete (Spain)

Background and Aims: The SARS-CoV-2 pandemic supposed a challenge in the management of patients with multiple sclerosis (MS), many of them with disease-modifying therapy (DMT)that may compromise their immune system. The aim of this study is to analyse the impact of the pandemic on the MS patient cohort of our centre in terms of incidence and severity of COVID and impact on MS. Methods: Retrospective descriptive study of MS patients with SARS-CoV-2 infection. We analysed demographic, clinical, laboratory and treatment variables. Results: Of 543 patients diagnosed with MS, 51 patients were affected by SARS-CoV-2 (9.3%). The baseline characteristics of this sample were: 66.7 % female, median age 44 years (range 18-71), 71 % relapsing-remitting MS, 13.7 % secondary progressive MS and 15.7 % primary progressive MS. The median baseline EDSS was 1.5 (interquartile range 0.75-6). 88.2 % were on DMT;62.7 % on long-term (> 24 months on same DMT). Treatment attitude was: 66.6 % no change, 27.3 % dose delay, 3 % transient discontinuation, 3 % change. Patients with MS and COVID presented with multiple symptoms, notably fever(62.7%), cough and asthenia(41.2%), dyspnoea( 19.6%), anosmia(11.8%) and headache(7.8%). 12% were asymptomatic. Bilateral pneumonia occurred in 28%, 13.7% required hospital admission. No patient died. There were 2 patients(4%) with a relapse. However, 18% had a worsening in EDSS score. EMPP subtype was associated with worsening in this period. In multivariate analysis there were no variables associated with worse outcome regarding the infection and MS. Conclusions: There were a low proportion of MS patients who suffered COVID19. Although there were some patients with severe presentation (pneumonia), there were no deaths. A significant proportion of MS patients with COVID worsen their disability status measured by EDSS, independent of relapses. Probably due to decreased physical activity due to confinement, but more studies are needed to confirm this hypothesis.