Characteristics and management of multiple sclerosis patients during the Omicron era: is there a concern about the MS course in the face of the new variant of COVID-19?

Abstract

Introduction The Omicron variant of COVID-19 is highly transmissible, triggering unprecedented infection rates. The present study aimed to investigate the course of multiple sclerosis (MS) in the Omicron era among Iranian patients with MS. Methods This observational study was designed on MS patients of the national MS registry of Iran through a self-designed online questionnaire. A questionnaire was prepared as a Google Form for MS patients during the Omicron outbreak from 1 March to 30 April 2022. Results One hundred seventy-four patients with a mean age of 37.3 ± 9.04 were enrolled. Of the patients, 95.97% used DMT, the most common of which were rituximab and fingolimod. Of the patients, 77.58% were fully vaccinated for COVID-19. Regardless of the COVID-19 vaccination status, 76 patients developed COVID-19, which was mild to moderate. Except for recent corticosteroid therapy and secondary progressive MS (SPMS), other demographic and MS characteristics were not significantly associated with the severity of COVID-19. There was also a marginal association between the Expanded Disability Status Scale (EDSS) and the severity of COVID-19. In addition, 17.10% of patients reported MS relapse following COVID-19 leading to escalation therapy in eight patients. Conclusion Our study demonstrated that in the Omicron era, most patients developed mild COVID-19. Although the predominant COVID-19 variant in this period was Omicron, we could not separate the pathogenic variants. The risk factors for COVID-19 during the Omicron era were not different from other pandemic waves. Our preliminary results revealed that the MS relapse following COVID-19 was higher than in previous waves.

COVID-19 infection after SARS-CoV-2 mRNA vaccination in Multiple Sclerosis, AQP4-antibody NMOSD and MOGAD patients during the Omicron subvariant BA.1/2 wave in Singapore

“…Our result is similar to the CovaXiMS cohort in Italy (which delineated infections during the Omicron and Delta waves) where the Omicron variant was found to increase the risk of infection by about 6 times above that during the Delta variant wave [7]. While the Omicron variant appeared to be highly transmissible and infective, it is reassuring that most infections in our cohort were mild (45/47 [95.7%]), in keeping with observations from MS patient cohorts worldwide [7,15]. Indeed, for our patients on anti-CD20s (which have been reported to have an increased risk of severe infections during previous infection waves) [16], 85.7% (12/14) were mild infections.…”

Influence of Disease Modifying Treatment, Severe Acute Respiratory Syndrome Coronavirus 2 Variants and Vaccination on Coronavirus Disease 2019 Risk and Outcome in Multiple Sclerosis and Neuromyelitis Optica

“…Associations were particularly strong for anti-CD20 treatment and the virus variant, which remained the only significant variables in the multivariate model. The association with neurological disability was not surprising, as several studies have reported higher EDSS scores among patients with severe COVID-19 [2,5,32,33]. Similarly, studies have shown that not only breakthrough infections, but also more severe COVID-19, occur more frequently in anti-CD20 treated MS patients [8,26].…”

The Role of Electroencephalography in the Prediction of Relapse of Febrile Convulsion in Patients Aged between 6 to 60 Months: A Prospective Cohort Study

“…18,19 However, some other committees of the American Academy of Neurology, The Child Neurology Society, and The American Epilepsy Society have noted that EEG can predict further episodes of seizure and recommend considering the EEG as an initial diagnostic tool after the first episode of FS. [20][21][22] Therefore, the role of EEG for patients with FS is not conclusive. However, some demographic and clinical factors investigated do predict abnormal EEG findings in patients with complex FS, including age >3 years and abnormal neurological investigations, as well as conducting EEG within first 7 days after FS.…”