Multiple sclerosis (MS) patients have been considered a higher-risk population for COVID-19 due to the high prevalence of disability and disease-modifying therapy use; however, there is little data identifying clinical characteristics of MS associated with worse COVID-19 outcomes. Therefore, we conducted a multicenter prospective cohort study looking at the outcomes of 40 MS patients with confirmed COVID-19. Severity of COVID-19 infection was based on hospital course, where a mild course was defined as the patient not requiring hospital admission, moderate severity was defined as the patient requiring hospital admission to the general floor, and most severe was defined as requiring intensive care unit admission and/or death. 19/40(47.5%) had mild courses, 15/40(37.5%) had moderate courses, and 6/40(15%) had severe courses. Patients with moderate and severe courses were significantly older than those with a mild course (57[50–63] years old and 66[58.8–69.5] years old vs 48[40–51.5] years old, P = 0.0121, P = 0.0373). There was differing prevalence of progressive MS phenotype in those with more severe courses (severe:2/6[33.3%]primary-progressing and 0/6[0%]secondary-progressing, moderate:1/14[7.14%] and 5/14[35.7%] vs mild:0/19[0%] and 1/19[5.26%], P = 0.0075, 1 unknown). Significant disability was found in 1/19(5.26%) mild course-patients, but was in 9/15(60%, P = 0.00435) of moderate course-patients and 2/6(33.3%, P = 0.200) of severe course-patients. Disease-modifying therapy prevalence did not differ among courses (mild:17/19[89.5%], moderate:12/15[80%] and severe:3/6[50%], P = 0.123). MS patients with more severe COVID-19 courses tended to be older, were more likely to suffer from progressive phenotype, and had a higher degree of disability. However, disease-modifying therapy use was not different among courses.

中文翻译：

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多发性硬化症患者中的 COVID-19 和严重感染的危险因素


由于残疾和疾病缓解疗法的使用率很高，多发性硬化症 (MS) 患者被认为是 COVID-19 的高危人群；然而，几乎没有数据确定 MS 的临床特征与更糟糕的 COVID-19 结局相关。因此，我们进行了一项多中心前瞻性队列研究，观察 40 名确诊为 COVID-19 的多发性硬化症患者的结果。 COVID-19感染的严重程度基于医院病程，其中轻度病程被定义为不需要住院的患者，中度严重度被定义为需要住院到普通楼层的患者，最严重的被定义为需要重症监护入院和/或死亡。 19/40（47.5%）为轻度病程，15/40（37.5%）为中度病程，6/40（15%）为重度病程。中度和重度病程患者年龄显着高于轻度病程患者（57[50–63]岁和66[58.8–69.5]岁 vs 48[40–51.5]岁，P = 0.0121，P = 0.0373 ）。在病程较严重的患者中，进行性 MS 表型的患病率不同（重度：2/6[33.3%]原发性进展和 0/6[0%]继发性进展，中度：1/14[7.14%] 和 5 /14[35.7%] 与轻度：0/19[0%] 和 1/19[5.26%]，P = 0.0075，1 未知）。轻度病程患者中有 1/19（5.26%）有明显残疾，中度病程患者有 9/15（60%，P = 0.00435），重度病程患者有 2/6（33.3%，P = 0.200）。当然-病人。疾病缓解治疗的患病率在不同疗程之间没有差异（轻度：17/19[89.5%]，中度：12/15[80%]，重度：3/6[50%]，P = 0.123）。患有更严重的 COVID-19 病程的多发性硬化症患者往往年龄较大，更有可能出现进行性表型，并且残疾程度更高。 然而，疾病缓解疗法的使用在不同疗程之间没有差异。