open access
Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies — the Polish experience
- Medical University of Białystok, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Faculty of Economic Sciences, University of Warsaw, Poland
- Department of Neurology, Specialist Hospital Ludwika Rydygiera in Krakow, Poland
- Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poland
- Department of Neurology, Poznan University of Medical Sciences, Poland
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
- Department of Neurology, Medical University of Warsaw, Poland
- Department of Neurology, Medical University of Warsaw, Poland
- Collegium Medicum UJK, and Clinical Center, RESMEDICA, Kielce, Poland
- Clinical Center, RESMEDICA, Kielce, Poland
- Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
- Department of Neurology, Specialist Hospital in Końskie, Poland
- Department of Urology, Specialist Hospital in Końskie, Poland
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, Bydgoszcz, Poland
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
- Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Poland
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
- Department of Neurology, Masovian Voivodeship Hospital in Siedlce, Poland
- Department of Neurology, Specialist Hospital in Pila, Poland
- Department of Neurology and Stroke, Medical University of Lodz, Poland
- Department of Neurology and Stroke Unit in Sandomierz, Collegium Medicum, Jan Kochanowski University in Kielce
- Department of Neurology, The Regional Hospital in Suwalki, Poland
- Department of Neurology, The Regional Hospital in Łomża, Poland
- KMK Clinical, MS Center, Katowice, Poland
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland
- Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland; Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland
- Neurology Ward, Provincial Integrated Hospital, Elbląg, Poland
- Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland; Clinic of Neurology, University of Warmia and Mazury, Olsztyn, Poland
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
- Department of Neurology, Specialist Hospital Dr Tytus Chałubiński Radom, Poland
- Department of Neurology, Specialist Hospital Dr Tytus Chałubiński Radom, Poland
- Department of Neurology, Regional Hospital in Skarżysko-Kamienna, Poland
- Department of Neurology and Ischemic Strokes, Medical University of Lodz, Poland
- Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Poland
open access
Abstract
Introduction. The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited.
Materials and methods. This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health.
Results. There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used.
Conclusions and clinical implications. Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs.
Abstract
Introduction. The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited.
Materials and methods. This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health.
Results. There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used.
Conclusions and clinical implications. Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs.
Keywords
multiple sclerosis, COVID-19, SARS-CoV-2, disease-modifying therapies
Title
Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies — the Polish experience
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Research Paper
Pages
212-222
Published online
2021-04-15
Page views
3945
Article views/downloads
1686
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2021;55(2):212-222.
Keywords
multiple sclerosis
COVID-19
SARS-CoV-2
disease-modifying therapies
Authors
Agata Czarnowska
Waldemar Brola
Olga Zajkowska
Stanisław Rusek
Monika Adamczyk-Sowa
Katarzyna Kubicka-Bączyk
Alicja Kalinowska-Łyszczarz
Karolina Kania
Agnieszka Słowik
Marcin Wnuk
Monika Marona
Aleksandra Podlecka-Piętowska
Monika Nojszewska
Beata Zakrzewska-Pniewska
Elżbieta Jasińska
Katarzyna Gołuch
Beata Lech
Magdalena Noga
Adam Perenc
Małgorzata Popiel
Anetta Lasek-Bal
Przemysław Puz
Katarzyna Maciejowska
Marta Kucharska-Lipowska
Michał Lipowski
Katarzyna Kapica-Topczewska
Monika Chorąży
Joanna Tarasiuk
Jan Kochanowicz
Joanna Kulikowska
Sławomir Wawrzyniak
Anna Niezgodzińska-Maciejek
Anna Pokryszko-Dragan
Ewa Gruszka
Sławomir Budrewicz
Marta Białek
Iwona Kurkowska-Jastrzębska
Katarzyna Kurowska
Adam Stępień
Agata Włodek
Violetta Ptasznik
Małgorzata Pawełczyk
Piotr Sobolewski
Henryka Lejmel
Katarzyna Strzalińska
Maciej Maciejowski
Andrzej Tutaj
Jacek Zwiernik
Anna Litwin
Bożena Lewańczyk
Izabela Paprocka
Beata Zwiernik
Aleksandra Pawlos
Andrzej Borysowicz
Anna Narożnik
Anna Michałowska
Krzysztof Nosek
Małgorzata Fudala
Marta Milewska-Jędrzejczak
Alina Kułakowska
Halina Bartosik-Psujek
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