COVID-19 in a neuroimmunology and multiple sclerosis referral unit

Introduction: Different studies suggest that, in general, multiple sclerosis and most immunomodulatory treatments are not a risk factor for COVID19. However, age, degree of disability, comorbidities and anti-CD20 treatments have been associated, in some studies, with an increase in SARS-CoV-2 infection and a worse prognosis due to COVID19. Neuroimmunology and multiple sclerosis units have adapted to the pandemic and have used different strategies to manage patients. COVID19 vaccination with different vaccines and different vaccination plans has recently started Objectives and Aims: The aim of this study is to describe the involvement of SARS-CoV-2 infection in a neuroimmunology and multiple sclerosis referral unit of 800,000 inhabitants Methods: Description of the cases affected by SARS-CoV-2 according to age, sex, type of multiple sclerosis, immunomodulatory treatments and comorbidities. The symptoms and evolution of the infection are described. The vaccination situation of the patients in the unit at the present time is described. Results: More than 50% of the patients seen in the unit have been screened. The percentage of cases infected by SARS-CoV-2 was 10%. Men and women have been affected equally. The mean age was 47 years. 73% of the positive patients were symptomatic. More than 90% of the patients presented mild symptoms and only 3 patients were hospitalized without the need for an ICU. Most were patients with relapsing-remitting multiple sclerosis. 36% of the positive cases were not treated with immunomodulatory drugs and the rest received different first or second line treatments. The comorbidities of the positive patients were tobacco, obesity, respiratory disease, diabetes, hypertension, dyslipidemia, heart disease and neoplasms. To date, more than 75% of patients treated with teriflunomide, dimethyl fumarate, fingolimod, cladribine, natalizumab, ocrelizumab, alemtuzumab, and rituximab have received one or two doses of different vaccines for COVID19. No vaccinated patient has developed the disease at the present time. Conclusion: Los datos de nuestra serie estan en concordancia con otros estudios, mostrando que la esclerosis múltiple per se y los diferentes tratamientos immunomoduladors no son un factor de riesgo para el COVID19. Es importante acelerar la vacunación de los pacientes con esclerosis múltiple para reducir la posibilidad de infección por SARS-CoV-2.