Author Of 1 Presentation
LB1252 - COVID-19 and multiple sclerosis – prevalence and the impact of disease modifying therapies (ID 2142)
Abstract
Background
There has been growing concern that disease modifying therapies (DMTs), as used in multiple sclerosis (MS), might increase the risk for an infection with SARS-CoV-2 and alter the clinical course of this infection.
Objectives
To assess the prevalence of COVID-19 in patients with MS (pwMS) and the potential impact of DMTs on its clinical course.
Methods
We used IBM Explorys, a data set covering electronic medical records of more than 72 million unique patients from hospitals in the United States, out of which we identified pwMS with and without PCR-confirmed COVID-19; we assessed baseline characteristics as well as DMTs for risk factors on the prevalence as well as a worse clinical outcome. Comparisons of cumulative prevalence of COVID-19, risk of hospitalization and death were made using logistic regression adjusted for patient age, sex, body mass index (BMI), comorbidities and race.
Results
We identified 30,116 pwMS with an open prescription for a DMT; 170 were COVID-19 positive. The risk of developing COVID-19 in pwMS did not appear to be higher when compared to patients with systemic lupus erythematosus (SLE), another chronic autoimmune disease (infection rate: 0.56% in MS vs. 0.58% in SLE; hospitalization: 30% vs. 36%; deaths: 3% vs 4%). PwMS with older age, male sex, high BMI, and cardiovascular disease were at higher risk to die in the context of this infection. PwMS on interferons appeared less likely to develop COVID-19 (0.35% of the overall group of pwMS) compared with high efficacy DMTs (p < .05), whereas anti-CD20 and anti-CD52 therapies were found to be associated with a higher risk of developing COVID-19 (1.67% and 1.15%) (p < .05).
Conclusions
Our findings demonstrate that MS is not prone to a higher or different risk of infection with SARS-CoV-2. Risk factors are similar to those reported for the general population. Some DMTs, however, appear to be associated with some level of protection, whereas others are associated with an increased risk for COVID-19. Such findings, once confirmed, might be taken into account when treating pwMS.
Supported by: Biogen