The incidence of COVID-19 in patients with multiple sclerosis (MS) was higher than in the general population, but most patients with this chronic inflammatory disorder did not need hospitalization. They generally had good outcomes despite having an increased number of comorbidities and the use of disease-modifying therapies (DMTs), according to study findings published in Neurology: Neuroimmunology & Neuroinflammation.
This cross-sectional, mixed-method study incorporated a survey patients with MS at the MS Unit of Hospital Clinic of Barcelona. The survey was a self-administered questionnaire sent via email to 586 patients with MS on May 21, 2020. Study investigators performed a telephone interview and reviewed electronic medical records of participants until June 18, 2020.
The study investigators examined the cumulative incidence of confirmed COVID-19 and all cases of COVID-19 that were either confirmed or suspected. They compared the cumulative incidence of confirmed cases as well as all COVID-19 cases from the beginning of the pandemic with overall population estimates for the Spanish city.
Approximately 69.5% of participants (n=407) who were emailed the questionnaire completed the survey. The median age of respondents was 48 years. Up to 84% of patients had relapsing-remitting disease. Nearly half of patients (45%) had at least 1 comorbidity, and the majority of patients (74.7%) were on DMT.
The rates of confirmed COVID-19 and suspected COVID-19 were 1.2% and 11.3%, respectively. While the cumulative incidence of confirmed COVID-19 was similar to the incidents reported in the general population (1.27% [95% CI, 0.18-2.36] vs 1.32% [95% CI, 1.30-1.34], respectively), it was 1.74-fold higher when all cases of confirmed and suspected COVID-19 were included (11.65% [95% CI, 9.31-15.75] vs 6.69% [95% CI, 6.65-6.73], respectively; P<.001).
Approximately 11.7% of patients were hospitalized, including 5 patients who experienced good recovery and 1 patient who died. Patients who were hospitalized were more frequently male (83% vs 26.6%; P=.012), more frequently had diabetes (33.3% vs 0%; P=.012), and more often had a progressive form of MS (50% vs 11%; P =.042) compared with patients who had a mild disease course, respectively.
Male sex was a significant risk factor associated with hospitalization when included in the multivariate logistic regression model (odds ratio, 13.08; 95% CI, 1.39-122.85; P=.024). No association was found between the use of DMT and risk of infection or outcome.
Limitations of this study included the reliance on self-reported data as well as the inclusion of only patients from a single center in Barcelona.
The study investigators noted that their findings need “to be confirmed with large population-based studies or larger registry studies.”
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Sepúlveda M, Llufriu S, Martínez-Hernández E, et al. Incidence and impact of COVID-19 in MS: A survey from a Barcelona MS unit. Neurol Neuroimmunol Neuroinflamm. 2021;8(2):e954. doi:10.1212/NXI.0000000000000954