ABSTRACT
Introduction: During the COVID-19 pandemic, the multidisciplinary team involved in the care of people with Multiple Sclerosis (pwMS) had to deal with many due to the vulnerability of these patients. A possible way to guarantee their management has been to use digital tools for surveillance and monitoring through remote contacts (telephone calls and e mails) to assess symptoms and needs. Aim: The aim of the study was to describe the vulnerability degree of a sample of pwMS that attend the rehabilitation centers at the beginning of the Covid-19 Pandemic. Methods: During April 1, 2020, to April 30, 2020 a multicenter observational retrospective study was conduct. The enrolment took place in five rehabilitation centers of North Italy (part of the country heavily affected by SARS-CoV-2 diffusion at the beginning of the Pandemic that followed mainly MS patients. Results: 2106 patients have been contacted, 2072 responded to the telephone interview about presence of symptoms and signs of Covid-19 infection (response rate: 98%). 99 (4.8%) subjects have been identified as Covid-19: 10 confirmed cases (tested positive for Covid-19) and 89 suspected Covid-19 symptoms. Two subjects (2.0%) were dead. There were no significant differences in gender, levels of disability (EDSS score) and use of disease modifying treatment between subjects with and those without Covid- 19. The Covid-19 patients had a younger age (53.1±10.4 vs. 56.5±12.7, p=0.06), a different distribution of MS course (16.2% vs 12.9% PP form;29.3% vs. 44.0% SP form and 54.5% vs 43.15 RR form, respectively, p=0.016) and a shorter duration of illness (12.6±10.6 vs. 17.2±11.1, p<0.001) than Covid-19 free ones. Conclusions: The MS Covid cases analyzed were younger, with lower percentages of SP form and with shorter disease duration than MS subjects Covid free. This could be explained by the higher probability to be in contact with other people and so higher probability of infection. In fact, subjects younger and with less severe form of disease have higher probability to move, work and to have social contacts. In conclusion, during the pandemic period the restriction to move are resulted the most effective indications, so it is urgent to implement use digital tools for surveillance and monitoring through remote contacts.