Background: People with multiple sclerosis (MS) may be at higher risk for complications from the 2019 coronavirus (COVID-19) pandemic due to use of immunomodulatory disease modifying therapies (DMTs) and greater need for medical services. Objectives: To evaluate risk factors for COVID-19 susceptibility and describe the pandemic’s impact on healthcare delivery. Methods: Surveys sent to MS patients at Cleveland Clinic, Johns Hopkins, and Vall d’Hebron-Centre d’Esclerosi Múltiple de Catalunya in April and May 2020 collected information about comorbidities, DMTs, exposures, COVID-19 testing/outcomes, health behaviors, and disruptions to MS care. Results: There were 3028/10,816 responders. Suspected or confirmed COVID-19 cases were more likely to have a known COVID-19 contact (odds ratio (OR): 4.38; 95% confidence interval (CI): 1.04, 18.54). In multivariable-adjusted models, people who were younger, had to work on site, had a lower education level, and resided in socioeconomically disadvantaged areas were less likely to follow social distancing guidelines. 4.4% reported changes to therapy plans, primarily delays in infusions, and 15.5% a disruption to rehabilitative services. Conclusion: Younger people with lower socioeconomic status required to work on site may be at higher exposure risk and are potential targets for educational intervention and work restrictions to limit exposure. Providers should be mindful of potential infusion delays and MS care disruption.

中文翻译：

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COVID-19 大流行期间的多发性硬化症管理

背景：由于使用免疫调节疾病改善疗法 (DMT) 和对医疗服务的更大需求，多发性硬化症 (MS) 患者可能因 2019 年冠状病毒 (COVID-19) 大流行而面临更高的并发症风险。目标：评估 COVID-19 易感性的风险因素并描述大流行对医疗保健服务的影响。方法：2020 年 4 月和 5 月发送给克利夫兰诊所、约翰霍普金斯大学和 Vall d'Hebron-Centre d'Esclerosi Múltiple de Catalunya 的 MS 患者的调查收集了有关合并症、DMT、暴露、COVID-19 检测/结果、健康行为的信息，以及对 MS 护理的干扰。结果：有 3028/10,816 名应答者。疑似或确诊的 COVID-19 病例更有可能与已知的 COVID-19 接触（优势比 (OR)：4.38；95% 置信区间 (CI)：1.04、18.54）。在多变量调整模型中，年龄较小、必须在现场工作、受教育程度较低且居住在社会经济弱势地区的人不太可能遵循社会疏远准则。4.4% 的人报告了治疗计划的变化，主要是输液延迟，15.5% 的人报告了康复服务的中断。结论：需要在现场工作的社会经济地位较低的年轻人可能面临更高的暴露风险，并且是教育干预和工作限制以限制暴露的潜在目标。提供者应注意潜在的输液延迟和 MS 护理中断。4% 的人报告了治疗计划的变化，主要是输液延迟，15.5% 的人报告了康复服务的中断。结论：需要在现场工作的社会经济地位较低的年轻人可能面临更高的暴露风险，并且是教育干预和工作限制以限制暴露的潜在目标。提供者应注意潜在的输液延迟和 MS 护理中断。4% 的人报告了治疗计划的变化，主要是输液延迟，15.5% 的人报告了康复服务的中断。结论：需要在现场工作的社会经济地位较低的年轻人可能面临更高的暴露风险，并且是教育干预和工作限制以限制暴露的潜在目标。提供者应注意潜在的输液延迟和 MS 护理中断。