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Risk of COVID-19 infection in MS and neuromyelitis optica spectrum disorders
Moli Fan1, Wei Qiu1, Bitao Bu1
1From the Department of Neurology (M.F., H.Y., J.C., P. Zheng., C. Zhang, F.-D.S.), Tianjin Medical University General Hospital; China National Clinical Research Center for Neurological Diseases (X. Zhang, F.-D-.S.), Jing-Jin Center for Neuroinfalmmation Beijing Tiantan Hospital, Capital Medical University; Department of Neurology (W.Q.), the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou; Department of Neurology (B.B.), Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan; Department of Neurology (Y.X.), Peking Union Medical College Hospital, Beijing; Xiangya Hospital of Central South University (H. Yang), Changsha; Department of Neurology (D. Huang), General Hospital of Chinese People's Liberation Army, Beijing; Division of Neurology (A.Y.L.), Department of Medicine and Therapeutics, Prince of Wales Hospital, the Chinese University of Hong Kong; Department of Neurology (J.G.), Tangdu Hospital, Air Force Military Medical University, Xi'an; Department of Neurology (M. Zhang), the First Affiliated Hospital of Shanxi Medical University, Taiyuan, China.
Objective:
Disease-modifying drugs (DMDs) may alter the immune status and thus increase the susceptibility to coronavirus disease 2019 (COVID-19) in patients with MS or neuromyelitis optica spectrum disorders (NMOSD). However, evidence supporting this notion is currently lacking. In this study, we conducted a survey on the risk of COVID-19 in patients with MS and NMOSD.
Methods:
The survey was conducted through the Chinese Medical Network for Neuroinflammation. Patients in 10 MS centers from 8 cities including Wuhan were included. Information about MS and NMOSD disease duration and the usage of DMDs were collected. Data of suspected cases of COVID-19 were obtained from hospital visits, questionnaires, and patient self-reporting. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was confirmed through clinical evaluation by a panel of experts in conjunction with chest CT and viral RNA detection.
Results:
Eight hundred eighty-two of 1,804 (48.89%) patients with MS and 2,129 of 3,060 (69.58%) patients with NMOSD were receiving DMDs. There were no alterations in the patients' DMD regimen during January 15, 2020, to March 15, 2020, the 3-month period. None of the patients with MS treated with DMDs had COVID-19. However, 2 patients with relapsing NMOSD were diagnosed with COVID-19-related pneumonia. After treatment, both patients recovered from pneumonia and neither patient experienced new attacks due to predisposing SARS-CoV-2 infection in the following 2 months.
Conclusions:
No increased risk of COVID-19 infection was observed in patients with MS or NMOSD, irrespective of whether these patients received DMDs. A battery of stringent preventive measures adopted by neurologists to reduce COVID-19 infection in these patients may have contributed to low risk of COVID-19 infection.
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