ABSTRACT
Background: Neurological disability associated with multiple sclerosis and immunosuppressive or immunomodulatory therapy which is administered for it may increase the risk of SARS-CoV-2 infection and its morbidity/mortality. In this study, we evaluated the severity of SARS-CoV-2 infection in patients with multiple sclerosis based on their demographic and disease data. Methods: A total of 1361 multiple sclerosis patients from Fars province were interviewed by phone from April 3 to June 20, 2020. Basic demographic data, information about their disease and any symptoms or laboratory results relevant to COVID-19 were gathered. Results: Among the studied patients, 68 ones (5%) were COVID-19 suspected cases and 8 ones (0.58%) were in the confirmed group. Five cases in the confirmed group needed hospitalization. Two patients died while both of them were taking rituximab. The frequency rate of suspected cases with RRMS was 57 (87.7%), followed by 5 (7.7%) PPMS and 2 (3.1%) CIS. In the confirmed group, 25% used corticosteroid drug and 50% were on rituximab;moreover, 62.5% of the confirmed cases had a high disability level and needed assistance to walk. In whole, 36.8% of the suspected and 25% of the confirmed cases were on IFN-β1;eventually, all of them recovered well from COVID-19 infection. Conclusion: In the present study, the rate of developing COVID-19 in multiple sclerosis patients was similar to the general population and most of patients with multiple sclerosis recovered from COVID-19 without referral to a medical specialist. © 2021, Kerman University of Medical Sciences. All rights reserved.
ABSTRACT
Introduction: There is little information on the symptoms, clinical characteristics, and outcomes of patients with Multiple Sclerosis (MS) who have the novel coronavirus disease 2019 (COVID-19) illness, especially for those admitted to the hospital. Objectives: Very little is currently known about the effects of COVID-19 on people with MS and vice versa. Aims: The purpose of this study was to determine the symptoms, clinical characteristics, and hospital outcomes of MS patients admitted to the hospital due to COVID-19. Methods: The current study is a multicenter case-control study that took place in Fars Province, Iran, from February 19 to November 20, 2020. All consecutive patients with a confirmed COVID-19 diagnosis were included, and all individuals with a history of MS were selected from the database. We also included two control groups with matching age and sex (patients with no history of an underlying disease and patients with a history of underlying disease). Results: From 38000 hospital admitted COVID-19 patients in the database, 25 had MS. Diabetes was the most common underlying disease in both MS patients and control groups, 11.5 % and 39.7 %, respectively. Fever and cough were the most common symptoms in MS patients. However, respiratory distress and low arterial oxygen saturation (<93%) were the most common symptoms in both control groups. Multivariate regression analysis revealed that the risk of loss of smell in MS patients was approximately 5 times (OR: 4.95 CI: 1.04-23.58 P=.04) and loss of taste 13 times (OR: 12.9 CI: 1.12-147.9 P=.04) higher than total control groups. There is no statistically significant difference in clinical outcome between MS patients and control groups, including ICU admission, the need for intubation, and in-hospital death. Conclusions: While the risk of loss of smell and loss of taste was higher in MS patients, hospital outcomes indices were not different.
ABSTRACT
Introduction: Iran is one of the countries with high prevalence of multiple sclerosis (MS) and COVID-19 infection. 2,691,352 patients with COVID- 19 have been identified including 75,568 deaths in Iran until May 12, 2021. Objectives: To determine Epidemiology and the risk of COVID- 19 infection among MS patients in Iran. Methods: The nationwide MS registry of Iran (NMSRI) has set up a COVID-19 infection program in 9 provinces of Iran in 2020. All MS cases with confirmed diagnosis of Covid-19 infection were registered in NMSRI. This system, registering baseline characteristics, clinical presentations and symptoms, diagnostic and treatments, hospital course and outcomes, identification the risk factors that develop Covid-19 infection and improving quality of care among MS patients in regional and national level. The neurologist registers new events into the dataset including demographic characteristics, definite diagnosis of COVID-19 and its symptoms, history of comorbidities, history of hospitalization, Changes in MRI and infection outcomes. Results: A total number of 408 MS cases including 320 (78.4%) females and 88 (21.6%) males enrolled in the study. The majority of subjects 299 (73.3%) had relapsing remitting MS. The mean (SD) of EDSS score was 1.88 (1.80) and 1.91 (1.92) before and after Covid-19 infection respectively (p value ≥0.05). Most common symptoms of infection included body aches 246 (60.3%), weakness and lethargy 242 (59.3%), fever 222 (54.4%), loss of sense of taste 206 (50.5%) and dry cough 167 (40.9%) respectively. The most common comorbidity was diabetes among 15 (3.7%) cases. Totally 77 (16.04%) cases were hospitalized and 4 (1%) were died. Conclusions: This study will provide valuable and novel epidemiological knowledge on Iranian MS patients with COVID-19. COVID-19 infection was more common among female and increased EDSS among subjects. The infection symptoms and mortality rate of COVID-19 in MS subjects are comparable to the general population.