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COVID-19 OUTCOMES IN MS: EARLY EXPERIENCE FROM NYU MULTIPLE SCLEROSIS COMPREHENSIVE CARE CENTER
medRxiv - Neurology Pub Date : 2020-05-18 , DOI: 10.1101/2020.05.12.20094508
Erica Parrotta , Ilya Kister , Leigh Charvet , Carrie Sammarco , Valerie Saha , R.E. Charlson , Jonathan Howard , Josef Maxwell Gutman , Malcolm Gottesman , Nada Abou-Fayssal , Robyn Wolintz , Marshall Keilson , Cristina Fernandez-Carbonell , Lauren B Krupp , Lana Zhovtis Ryerson

Objective: Report outcomes on patients with Multiple Sclerosis (MS) and related disorders with COVID-19 illness. Methods: From March 16 to April 30th, 2020, patients with MS or related disorders at NYU Langone MS Comprehensive Care Center (MSCC) were identified with laboratory-confirmed or suspected COVID-19. The diagnosis was established using a standardized questionnaire or by a review of in-patient hospital records. Results: We identified 76 patients (55 with relapsing MS of which 9 had pediatric-onset;17 with progressive MS; and 4 with related disorders). 37 underwent PCR testing and were confirmed positive. Of the entire group, 64 (84%) patients were on disease-modifying therapy (DMT) including anti-CD20 therapies (n=34, 44.7%) and sphingosine 1-phosphate receptor modulators (n=10, 13.5%). The most common COVID-19 symptoms were fever and cough, but 21.1% of patients had neurologic symptom recrudescence preceding or coinciding with the infection. A total of 18 (23.7%) were hospitalized; 8 (10.5%) had COVID-19 critical illness or related death. Features more common among those hospitalized or with critical illness or death were older age, presence of comorbidities, progressive disease, and a non-ambulatory status. No DMT class was associated with an increased risk of hospitalization or fatal outcome. Conclusions: Most MS patients with COVID-19 do not require hospitalization despite being on DMTs. Factors associated with critical illness were similar to the general at risk patient population. DMT use did not emerge as a predictor of poor COVID-19 outcome in this preliminary sample.

中文翻译:

MS患者中COVID-19的结果:纽约大学多发性硬化综合护理中心的早期经验

目的:报告多发性硬化症(MS)和相关疾病合并COVID-19疾病的患者的结局。方法:从2020年3月16日至4月30日,在纽约大学朗格尼综合治疗中心(MSCC)对MS或相关疾病的患者进行实验室确认或怀疑的COVID-19鉴定。诊断是通过使用标准调查表或通过对住院医院记录的回顾来确定的。结果:我们确定了76例患者(55例复发性MS,其中9例患儿; 17例进行性MS; 4例相关疾病)。37位患者接受了PCR检测,并被证实为阳性。在整个组中,有64名(84%)患者正在接受疾病改良疗法(DMT),包括抗CD20治疗(n = 34,44.7%)和鞘氨醇1-磷酸受体调节剂(n = 10,13.5%)。最常见的COVID-19症状是发烧和咳嗽,但21.1%的患者在感染之前或与感染并发时出现神经系统症状复发。共有18人(23.7%)住院;8名(10.5%)患有COVID-19严重疾病或相关死亡。在那些住院或患有严重疾病或死亡的人中,更普遍的特征是年龄大,合并症,进行性疾病和非卧床状态。没有DMT类别与住院或致命结果风险增加相关。结论:尽管有DMT,大多数COVID-19的MS患者无需住院。重症患者的相关因素与高危人群相似。在该初步样本中,DMT的使用并未成为COVID-19不良预后的预测指标。1%的患者在感染之前或与感染同时发生神经系统症状复发。共有18人(23.7%)住院;8名(10.5%)患有COVID-19严重疾病或相关死亡。在那些住院或患有严重疾病或死亡的人中,更普遍的特征是年龄大,合并症,进行性疾病和非卧床状态。没有DMT类别与住院或致命结果风险增加相关。结论:尽管有DMT,大多数COVID-19的MS患者无需住院。重症患者的相关因素与高危人群相似。在该初步样本中,DMT的使用并未成为COVID-19不良预后的预测指标。1%的患者在感染之前或与感染同时发生神经系统症状复发。共有18人(23.7%)住院;8名(10.5%)患有COVID-19严重疾病或相关死亡。在那些住院或患有严重疾病或死亡的人中,更普遍的特征是年龄大,合并症,进行性疾病和非卧床状态。没有DMT类别与住院或致命结果风险增加相关。结论:尽管有DMT,大多数COVID-19的MS患者无需住院。重症患者的相关因素与高危人群相似。在该初步样本中,DMT的使用并未成为COVID-19不良预后的预测指标。5%)患有COVID-19严重疾病或相关死亡。在那些住院或患有严重疾病或死亡的人中,更常见的特征是年龄大,合并症,进行性疾病和非卧床状态。没有DMT类别与住院或致命结果风险增加相关。结论:尽管有DMT,大多数COVID-19的MS患者不需要住院。重症患者的相关因素与高危人群相似。在该初步样本中,DMT的使用并未成为COVID-19不良预后的预测指标。5%)患有COVID-19严重疾病或相关死亡。在那些住院或患有严重疾病或死亡的人中,更普遍的特征是年龄大,合并症,进行性疾病和非卧床状态。没有DMT类别与住院或致命结果风险增加相关。结论:尽管有DMT,大多数COVID-19的MS患者无需住院。重症患者的相关因素与高危人群相似。在该初步样本中,DMT的使用并未成为COVID-19不良预后的预测指标。没有DMT类别与住院或致命结果风险增加相关。结论:尽管有DMT,大多数COVID-19的MS患者无需住院。重症患者的相关因素与高危人群相似。在该初步样本中,DMT的使用并未成为COVID-19不良预后的预测指标。没有DMT类别与住院或致命结果风险增加相关。结论:尽管有DMT,大多数COVID-19的MS患者无需住院。重症患者的相关因素与高危人群相似。在该初步样本中,DMT的使用并未成为COVID-19不良预后的预测指标。
更新日期:2020-05-18
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