Abstract
Objective: To determine outcomes of COVID-19 in patients with Multiple Sclerosis (MS) and related conditions, and to determine predictors of these outcomes.
Methods: This was a multicenter, observational cohort study of patients with MS or related CNS autoimmune disorders who developed confirmed or highly suspected COVID-19 infection from 2/1/2020 to 12/31/2020.
Main outcome and measure: The primary outcome measure was hospitalization status due to COVID-19. Severity of infection was measured using a 4-point ordinal scale: 1. home care; 2. hospitalization without mechanical ventilation; 3. hospitalization and mechanical ventilation, and 4. death.
Results: Of 474 patients in the study, 63.3% had confirmed COVID-19 infection and 93.9% were diagnosed with an MS phenotype. Mean age was 45 ± 13 (mean±SD) years, 72% were female, and 86% were treated with a DMT at the time of infection. 58 patients (12.2%) were hospitalized. 24 patients (5.1%) were critically ill (requiring ICU care or outcome of death), of which 15 patients (3.2%) died. Higher neurological disability and older age independently predicted hospitalization. 85% (102/120) of patients with known antibody results not treated with anti-CD20 therapies were seropositive while only 39.5% (17/43) of patients treated with anti-CD20 demonstrated seropositivity (p < 0.0001). Only 25% (2/8) of patients with PCR-confirmed COVID-19 being treated with anti-CD20 therapies demonstrated seropositivity.
Conclusions: Neurological disability and older age independently predicted hospitalization due to COVID-19. Additionally, the results demonstrate that anti-CD20 therapies significantly blunt humoral responses post-infection, a finding that carries implications with regards to natural or vaccine-mediated immunity.
Keywords: Anti-CD20 therapy; Antibody; COVID-19; Multiple Sclerosis.
【저자키워드】 COVID-19, multiple sclerosis, antibody, anti-CD20 therapy, 【초록키워드】 Hospitalized, mechanical ventilation, Hospitalization, Infection, outcome, outcomes, Critically ill, Humoral response, COVID-19 infection, female, Patient, Older age, death, phenotype, age, predictor, multicenter, CNS, seropositive, anti-CD20, neurological, Observational cohort study, Post-infection, ICU care, primary outcome measure, Confirmed COVID-19 infection, PCR-confirmed COVID-19, Multiple, sclerosis, implication, autoimmune disorder, vaccine-mediated immunity, was measured, predicted, died, significantly, diagnosed, treated, determine, demonstrated, conditions, blunt, COVID-19 in patient, patients treated, 【제목키워드】 pandemic, multiple sclerosis, COVID-19 infection, Neuroimmunology, multicenter, New York,