COVID-19 in multiple sclerosis and neuromyelitis optica spectrum disorder patients in Latin America

Abstract

Background There is no data regarding COVID-19 in Multiple Sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) patients in Latin America. Objective The objective of this study was to describe the clinical characteristics and outcomes of patients included in RELACOEM, a LATAM registry of MS and NMOSD patients infected with COVID-19. Methods RELACOEM is a longitudinal, strictly observational registry of MS and NMOSD patients who suffer COVID-19 and Dengue in LATAM. Inclusion criteria to the registry were either: (1) a biologically confirmed COVID-19 diagnosis based on a positive result of a COVID-19 polymerase chain reaction (PCR) test on a nasopharyngeal swab; or (2) COVID-19–typical symptoms (triad of cough, fever, and asthenia) in an epidemic zone of COVID-19. Descriptive statistics were performed on demographic and clinical variables. The cohort was later stratified for MS and NMOSD and univariate and multivariate logistic regression analysis was performed to identify variables associated with hospitalizations/intensive critical units (ICU) admission. Results 145 patients were included in the registry from 15 countries and 51 treating physicians. A total of 129 (89%) were MS patients and 16 (11%) NMOSD. 81.4% patients had confirmed COVID-19 and 18.6% were suspected cases. 23 (15.8%) patients were hospitalized, 9 (6.2%) required ICU and 5 (3.4 %) died due to COVID-19. In MS patients, greater age (OR 1.17, 95% CI 1.05 – 1.25) and disease duration (OR 1.39, 95%CI 1.14-1.69) were associated with hospitalization/ICU. In NMOSD patients, a greater age (54.3 vs. 36 years, p=<0.001), increased EDSS (5.5 vs 2.9, p=0.0012) and disease duration (18.5 vs. 10.3 years, p=0.001) were significantly associated with hospitalization/ICU. Conclusion we found that in MS patients, age and disease duration was associated with hospitalization and ICU admission requirement, while age, disease duration and EDSS was associated in NMOSD.

Multiple sclerosis, neuromyelitis optica spectrum disorder and COVID-19: A pandemic year in Czechia

“…To date, there are only a few published cases of COVID-19 in patients with NMOSD (Alonso et al, 2021;Ciampi et al, 2020;Creed et al, 2020;Fan et al, 2020;Louapre et al, 2020b;Sahraian et al, 2020;Zeidan et al, 2020b). From 46 confirmed or highly suspected patients with COVID-19, 20 (43.48%) had a mild infection course, 20 (43.48%) HDG2 = high dose glucocorticoid during the previous 2 months, F = female, M = male, COVID-19 severity score: 2 = symptomatic patient, 3 = patient with suspected pneumonia defined by both dry cough and shortness of breath, 4 = patient with radiologically confirmed pneumonia (chest X-ray or CT scan), 8 = death required hospitalisation and 6 (13.04%) patients died from COVID-19.…”

“…However, the effect of immunomodulatory therapies on the course of COVID-19 has not been satisfactorily elucidated yet. As for NMOSD, reports on COVID-19 infection are scarce, but the available data (Alonso et al, 2021;Ciampi et al, 2020;Creed et al, 2020;Fan et al, 2020;Louapre et al, 2020b;Sahraian et al, 2020;Zeidan et al, 2020a) indicates a high proportion of hospitalized patients and a high mortality rate among these patients.…”

Update on the management of multiple sclerosis during the COVID-19 pandemic and post pandemic: An international consensus statement

“…Access to information on COVID-19 has been inconsistent to low-income populations, possibly increasing risk to people with limited access to real-time updates ( Mansoor et al, 2020 ). Middle-income countries have reported their experiences, including China ( Fan et al, 2020 ), Iran ( Safavi et al, 2020 ), Chile and other Latin American countries ( Alonso et al, 2021 ; Ciampi et al, 2020 ; Guevara et al, 2020 ). However, national registries for pwMS in most lower income regions are absent, limiting any inferences that can be drawn.…”

Coronavirus disease 2019 in Latin American patients with multiple sclerosis

“…A recent Latin American study reported that there were no deaths associated with COVID-19 in a cohort of 129 patients with MS 2 . Older age and longer disease duration were the two factors associated with higher risk of hospitalization in this cohort.…”