Author Of 1 Presentation
LB1181 - COVID-19 Outcomes among patients with Multiple Sclerosis: Experience from RWJBH Multiple Sclerosis Comprehensive Care Center (ID 1965)
Abstract
Background
COVID-19 is a pandemic caused by the novel coronavirus, SARS-CoV-2. Disease-modifying therapies (DMTs) used to treat Multiple Sclerosis (MS) act primarily by altering the immune system. While many DMTs have well understood mechanisms of action, the consequences of immunomodulation in the setting of exposure to a novel viral pathogen were largely unknown until recently.
Objectives
Analyze clinical outcomes and risk of treatment with DMTs among patients with MS and related disorders who contracted COVID-19.
Methods
From March 10to July 1st, 2020, patients with MS and related disorders at RWJBH MS Comprehensive Care Center (MSCCC) with laboratory-confirmed COVID-19 were identified. The diagnosis was established through the nurse triage telephone line, telehealth visits with physicians, and review of medical records with subsequent clinical follow up.
Results
We identified 25 patients (13 with relapsing MS; 11 with progressive MS; and 1 with Neuromyelitis Optica Spectrum Disorder (NMOSD)) with laboratory-confirmed COVID19, either polymerase chain reaction (PCR) or serologic testing for SARS-CoV-2 antibodies. Of the entire cohort, 23 (92%) were on DMTs, with the majority on either anti-CD20 monoclonal therapies 10/25 (40%) or dimethyl fumarate 7/25 (28%). A total of 21 (84%) are fully recovered or recovering; 1 (4%) never developed symptoms; 8 (32%) required hospitalization; and 3 (12%) are deceased. Among those hospitalized, 5/8 (62.5%) were on anti-CD20 therapies. While the majority of our sample of MS patients had relapsing MS 13/24 (54.2%), the majority of hospitalized patients had progressive MS 5/8 (62.5.8%). Among the cohort, 9/25 (36%) were tested for anti-SARS-CoV-2 antibodies, 8/9 (88.9%) had detectable antibodies while 1/9 (11.1%) did not, likely as a consequence of peripheral B lymphocyte depletion.
Conclusions
Although nearly all patients at our MS center who contracted COVID-19 were on DMTs, most did not require hospitalization. According to June 2020 data from the Centers for Disease Control and Prevention (CDC), 14% of patients with COVID-19 in the US required hospitalization, and 5% died. While the proportion of patients on DMT requiring hospitalization was higher than that reported for the general population, the mortality rate was similar.