Shiraz University of Medical Sciences, Shiraz, Iran.

Author Of 1 Presentation

COVID-19 Late Breaking Abstracts

LB1266 - Descriptive data analysis of covid-19 among patients with multiple  sclerosis; A cross-sectional study of southern Iran (ID 2164)

Presentation Number
LB1266
Presentation Topic
COVID-19

Abstract

Background

The managing of patients who receive immunosuppressive or immunomodulatory drugs rapidly has to change during the current coronavirus disease 2019 (COVID-19) pandemic. Immunosuppression therapy combined with neurological disability such as multiple sclerosis (MS) increases the risk of severe COVID-19 and associated death. Hence, evaluating the risk of Covid-19 in MS patients is an important issue in global healthcare system and demand for data to describe the frequency and the evolution of COVID-19 infection in MS patients grows rapidly around the world.

Objectives

We report our descriptive-analytic study on MS patients with a confirmed or suspected COVID-19. This study was conducted in south of Iran, an area with a high prevalence and incidence of MS. It is also worth noting that Iran is high in prevalence of COVID- 19 and this study was performed in the first pandemic wave in Iran.

Methods

1361 MS patients from fars province, south of Iran were contacted from April 3 to June 20, 2020. Basic demographic data, information about MS disease and any signs, symptoms or laboratory results relevant to COVID-19 were gathered. SPSS version 22 was used for data analysis. P< 0.05 was considered statistically significant.

Results

The frequency of DMT were as follow: rituximab 27.6%, interferons 27.3%, fingolimod 12.5%, dimethyl fumarate 9.1%, glatiramer acetate 7.3%, teriflunomide 1.9%, natalizumab 1.3%. Out of 1361 patients, 68 (5) % were COVID-19 suspected cases. 12 patients showed serious clinical symptoms and required hospital admission. 8 cases had positive PCR, 6 of confirmed cases did not require ICU care or intubation and were discharged from the hospital. 2 of the COVID-19 confirmed cases died. Both of them were on rituximab. The highest frequency of suspected cases had RRMS 87.7%, followed by PPMS7.7% and the lowest percentage of suspected cases was observed in SPMS patients 1.5%. 50% of confirmed cases and 12.5% of suspected cases were on rituximab. .There was significant difference in frequency rate of patients who used corticosteroid (p <0.005) and cardiovascular drugs (p =0.04). 62.5% of confirmed cases had EDSS 6 or higher while 6.4% of suspected and 10.1% of healthy cases requires assistance to walk. In the multivariable regression model, CVD and hyperthyroidism were independently associated with the risk of the suspect or confirmed COVID-19. Patients with hyperthyroidism and CVD were approximately 21.3 and 3.6 times higher at risk of infection.( OR=21.3 95% CL2.95-55.08 P=0.002) (OR=3.69 95% CL1.47-9.21, P=0.005) respectively.

Conclusions

In general, risk of covid- 19 infection and severity and mortality in pwMS seems not to be more than other population; however, type of disease modifying drug, comorbidities and physical disability are the main factors which may threaten these patients. our study showed PPMS and CIS types as well as cases with hyperthyroid and cardiovascular diseases are in a higher risk than the other MS patients.

Collapse