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. 2020 Aug:43:102195.
doi: 10.1016/j.msard.2020.102195. Epub 2020 May 13.

B-cell depleting therapies may affect susceptibility to acute respiratory illness among patients with multiple sclerosis during the early COVID-19 epidemic in Iran

Farinaz Safavi  1 , Bardia Nourbakhsh  2 , Amir Reza Azimi  3
Affiliations

B-cell depleting therapies may affect susceptibility to acute respiratory illness among patients with multiple sclerosis during the early COVID-19 epidemic in Iran

Farinaz Safavi et al. Mult Scler Relat Disord. 2020 Aug.

Abstract

Objective: To determine whether the course of COVID-19 is more severe in patients with MS and if MS disease-modifying treatments (DMTs) affect the risk of contracting the disease.

Methods: In a cross-sectional survey, data were collected by sending a questionnaire to 2000 patients with a demyelinating disease through an online portal system. Collected data included the current MS DMT and patient-reported disability level, history of recent sick contact, recent fever, respiratory symptoms, diagnosis with COVID-19, and the disposition after the diagnosis. We defined a COVID-19-suspect group as patients having fever and cough or fever and shortness of breath, or a presumptive diagnosis based on suggestive chest computed tomography. We calculated the proportion of COVID-19-suspect patients and compared their demographics, clinical characteristics, and DMT categories with the rest of survey-responders, using univariable and multivariable models.

Results: Out of 712 patients, 34 (4.8%) fulfilled our criteria for being in the COVID-19-suspect group. Only two patients required hospitalization. No patient required intensive care. In a multivariable model, disease duration (p-value=0.017), DMT category (p-value=0.030), and history of sick contact (p-values<0.001) were associated with the risk of being in the COVID-19-suspect group. Being on B-cell depleting antibodies (as compared to non-cell depleting, non-cell trafficking inhibitor DMTs) was associated with a 2.6-fold increase in the risk of being in the COVID-19-suspect group. (RR: 3.55, 95%CI: 1.45, 8.68, p-value=0.005).

Conclusions: The course of infection in patients with MS suspected of having COVID-19 was mild to moderate, and all patients had a full recovery. B-cell depleting antibodies may increase the susceptibility to contracting COVID-19.

Keywords: B-cell depleting therapies; COVID-19; DMTs; Multiple Sclerosis.

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Conflict of interest statement

Declaration of Competing Interest Farinaz Safavi declares no financial conflict of interest. Bardia Nourbakhsh declares no financial conflict of interest. Amir Reza Azimi declares no financial conflict of interest.

Comment in

  • Characteristics of COVID-19 disease in multiple sclerosis patients.
    Barzegar M, Mirmosayyeb O, Ghajarzadeh M, Nehzat N, Vaheb S, Shaygannejad V, Vosoughi R. Barzegar M, et al. Mult Scler Relat Disord. 2020 Oct;45:102276. doi: 10.1016/j.msard.2020.102276. Epub 2020 Jun 8. Mult Scler Relat Disord. 2020. PMID: 32652473 Free PMC article. No abstract available.

References

    1. Barrat F.J., Crow M.K., Ivashkiv L.B. Interferon target-gene expression and epigenomic signatures in health and disease. Nat Immunol. 2019;20(12):1574–1583. - PMC - PubMed
    1. Borriello G, I.A. Natalizumab treatment: a case report in a patient with extended interval dosing approach. Mult Scler Relat Disord. 2020 doi: 10.1016/j.msard.2020.102165. Epub ahead of print. - DOI - PMC - PubMed
    1. Cao X. COVID-19: immunopathology and its implications for therapy. Nat Rev Immunol. 2020;20(5):269–270. - PMC - PubMed
    1. Cohen J.A., Barkhof F., Comi G., Hartung H.P., Khatri B.O., Montalban X., Pelletier J., Capra R., Gallo P., Izquierdo G., Tiel-Wilck K., de Vera A., Jin J., Stites T., Wu S., Aradhye S., Kappos L. Oral fingolimod or intramuscular interferon for relapsing multiple sclerosis. N Engl J Med. 2010;362(5):402–415. - PubMed
    1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y., Zhang L., Fan G., Xu J., Gu X., Cheng Z., Yu T., Xia J., Wei Y., Wu W., Xie X., Yin W., Li H., Liu M., Xiao Y., Gao H., Guo L., Xie J., Wang G., Jiang R., Gao Z., Jin Q., Wang J., Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. - PMC - PubMed

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