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Observational Study
. 2021 Oct;28(10):3461-3466.
doi: 10.1111/ene.14612. Epub 2020 Nov 27.

Outcomes of coronavirus disease 2019 in patients with neuromyelitis optica and associated disorders

Céline Louapre  1 , Elisabeth Maillart  1 , Caroline Papeix  1 , Sinead Zeidan  1 , Damien Biotti  2 , Zoé Lepine  2 , Abir Wahab  3 , Mickael Zedet  4 , Pierre Labauge  5 , Caroline Tilikete  6 , Julie Pique  7 , Ayman Tourbah  8 , Guillaume Mathey  9   10 , Dalia Dimitri Boulos  11 , Pierre Branger  12 , Laurent Daniel Kremer  13 , Romain Marignier  7 , Nicolas Collongues  13 , Jérôme De Seze  13
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Free article
Observational Study

Outcomes of coronavirus disease 2019 in patients with neuromyelitis optica and associated disorders

Céline Louapre et al. Eur J Neurol. 2021 Oct.
Free article

Abstract

Background: Outcomes of coronavirus disease 2019 (COVID-19) in patients with neuromyelitis optica spectrum disorders (NMOSD) or myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), often treated with immunosuppressive therapies, are still unknown.

Methods: We conducted a multicenter, retrospective, observational cohort study among all French expert centers for neuromyelitis optica and related disorders. Patients with NMOSD or MOGAD included in the study received a confirmed or highly suspected diagnosis of COVID-19 between 1 March 2020 and 30 June 2020. Main outcome was COVID-19 severity score assessed on a seven-point ordinal scale ranging from 1 (not hospitalized with no limitations on activities) to 7 (death).

Results: Fifteen cases (mean [SD] age: 39.3 [14.3] years, 11 female) were included. Five patients (33.3%) were hospitalized, all receiving rituximab. A 24-year-old patient with positive aquaporine-4 antibody, with obesity as comorbidity, needed mechanical ventilation. Outpatients were receiving anti-CD20 (5), mycophenolate mofetil (3) or azathioprine (3). They were younger (mean [SD] age: 37.0 [13.4] years), with a longer disease duration (mean [SD]: 8.3 [6.3] years) and had a lower expanded disability severity score (EDSS) score (median [range] EDSS: 2.5 [0-4]) relative to patients requiring hospitalization (mean [SD] age: 44.0 [16.4] years, mean [SD] disease duration: 5.8 [5.5] years, median [range] EDSS: 4 [0-6.5]).

Conclusions: COVID-19 outcome was overall favorable in this cohort. Larger international studies are needed to identify risk factors of severe COVID-19; however, we recommend personal protective measures to reduce risk of SARS-CoV-2 infection in this immunocompromised population.

Keywords: COVID-19; MOGAD; NMOSD; immunosuppressant.

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References

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