Neuro-immunological disorders during the COVID-19 pandemia: An Argentinian hospital based study

Objective: The aim of this case-series study is to describe the prevalence and characteristics of COVID-19 in Argentinean patients with neuro-immunological disorders. Background: A new infection caused by SARS-CoV2 emerged in China in December 2019 and has rapidly spread worldwide to become a pandemic. In South America, this virus is now reaching its peak. The first case of COVID-19 in Argentina was reported on 3/3/2020 and now this virus is reaching its peak. Patients with neuro-immunological disorders may be at higher risk for complications from SARS-CoV2 and due to use of immunomodulatory therapies. Design/Methods: We performed an observational study at the Neuroimmunology Section of Ramos Mejia Hospital, a Public Hospital of Buenos Aires City, Argentina of patients with neuroimmunological disorders who contracted COVID-19 infection. Results: We identified 15 patients (out of 620) with chronic neuro-immunological diseases who developed active coronavirus infection at the Neuroimmunology Unit of Ramos Mejia Hospital. Six patients had diagnosis of Multiple Sclerosis (MS), seven had Myasthenia Gravis (MG), one Neuromyelitis Optic Spectrum Disorders (NMOSD) and the other with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). Three patients (two MG and one MS) required artificial respiratory ventilation. The outcome was poor in two patients (one MS and the other MG) who were over 60 years old and had at least one underlying medical condition, who died during hospitalization. Seven out of 10 patients were undergoing immune treatment. Three patients under treatment with anti-CD20 therapy (rituximab for 2 MG patients and ocrelizumab for one MS patient) progressed without respiratory complications and good outcomes. Conclusions: Our findings suggest that the clinical course and outcomes in patients with neuroimmunological disorders are highly variable. Further studies are necessary to confirm these preliminary observations and to define the best practice for this population.