Evaluation of the rate of COVID-19 infection, hospitalization and death among Iranian patients with multiple sclerosis

Mult Scler Relat Disord. 2020 Nov:46:102472. doi: 10.1016/j.msard.2020.102472. Epub 2020 Aug 29.

Abstract

Background: COVID-19 is increasingly expanding all over the world. People who have an underlying disease or taking immunosuppressive drugs are generally more likely to be infected than the others. Multiple sclerosis (MS) patients may also be at risk of the disease and its complications depending on the medication they are taking. In this study, we evaluated a large population of patients with MS with different disease modifying drugs to show if any of them increases the risk. In addition, this study evaluates the incidence of COVID-19 in patients with MS, the rate of hospitalization or death in these patients.

Method: This study was performed at the MS Clinic of Sina Hospital. All patients were contacted and their demographic characteristics were recorded. They were then asked about their COVID-19 symptoms. Patients with these symptoms were further evaluated. The documents were reviewed by treating neurologist and MS nurses to be sure about diagnosis of COVID19. The positive polymerase chain reaction (PCR) result or compatible lung computed tomography (CT) scan was acceptable for COVID-19 diagnosis.

Results: 4647 patients answered the phone contact. Of these, 68 were infected with the COVID-19. The rate of hospitalization was 25% which is far more than general population. Two patients died from COVID-19. Rituximab was associated with increase rate of COVID-19 infection but not with hospitalization rate. There was no significant correlation between use of other drugs and rate of infection.

Conclusion: This study revealed that the incidence of COVID-19 in MS patients is not more than general population, but the risk of hospitalization in these patients is higher than estimated for the disease. This highlights the importance of communicating to patients the severity of COVID-19 and the importance of risk reduction behaviors like social distancing and mask use.

Keywords: COVID-19; Death; Hospitalization; Multiple sclerosis.

MeSH terms

  • Adult
  • COVID-19 / epidemiology
  • COVID-19 Drug Treatment*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Incidence
  • Iran
  • Male
  • Middle Aged
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / epidemiology*
  • Rituximab / therapeutic use
  • SARS-CoV-2 / drug effects
  • SARS-CoV-2 / pathogenicity

Substances

  • Immunosuppressive Agents
  • Rituximab