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Characteristics of pediatric patients with multiple sclerosis and related disorders infected with SARS-CoV-2

Teri Schreiner1, Molly Wilson-Murphy2, Jan Mendelt-Tillema3

  • 1Department of Pediatrics and Neurology, Children's Hospital of Colorado, University of Colorado, Aurora, CO, USA.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|March 24, 2023
PubMed

Insights

B-cell-depleting therapy in pediatric patients with multiple sclerosis and related disorders increases the risk of severe COVID-19, including hospitalization and ICU admission. This finding informs treatment decisions for these vulnerable patients.

Area of Science:

  • Pediatric neurology
  • Infectious disease epidemiology
  • Immunology

Background:

  • Pediatric patients with multiple sclerosis (POMS) and related disorders, including clinically isolated syndrome (CIS), myelin oligodendrocyte glycoprotein antibody disorder (MOGAD), and neuromyelitis optica spectrum disorder (NMOSD), often receive immunosuppressive treatments.
  • Understanding the effects of SARS-CoV-2 infection in this population is crucial for guiding therapeutic choices.

Purpose of the Study:

  • To determine the prevalence and severity of SARS-CoV-2 infections in pediatric patients with POMS and related disorders.
  • To assess the impact of disease-modifying therapies (DMTs) on COVID-19 outcomes in this cohort.

Main Methods:

  • A prospective registry of POMS and related disorders patients was utilized.
  • Patients were screened for COVID-19 during routine neurology visits.
  • Confirmed COVID-19 cases underwent further analysis.

Main Results:

  • Out of 669 patients surveyed (March 2020 - August 2021), 73 had confirmed COVID-19 infections.
  • Hospitalized patients (89%) and all ICU admissions were on B-cell-depleting therapy.
  • B-cell-depleting therapy was associated with a significantly higher odds ratio (15.27) for hospitalization among COVID-19 positive patients (p=0.016).

Conclusions:

  • B-cell-depleting treatment correlates with increased risk of COVID-19, hospitalization, and ICU admission in POMS and related disorders.
  • This suggests that B-cell-depleting therapy poses a higher risk for severe infections in this pediatric population.
Abstract

Keywords:
Multiple sclerosisdemyelinationdisease-modifying therapiesneuromyelitis opticaoutcome measurement

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