Abstract
Introduction: The information about the frequency of COVID-19 and its outcomes in people with Multiple Sclerosis (MS) in Colombia is practically non-existent. We aimed to describe the frequency characteristics and factors associated with of COVID-19 in a sample of patients with MS.
Materials and methods: Descriptive and retrospective analysis of patients diagnosed with Multiple Sclerosis criteria who attended our center between June and October 2021. Patients provided information about SARS-CoV-2 infection and their vaccination. COVID-19 determinants were analyzed using uni- and multivariable binomial logistic regression models.
Results: 240 patients were analyzed, of whom 71% were women, with a mean age of 34 years. The majority of patients were on disease-modifying therapies and over 80?% were vaccinated. 69 patients reported having had covid-19. In multivariable models, age (OR 0.96; 95?% CI 0.93-0.99) was the only factor associated with a lower odds of COVID-19 infection.
Discussion: COVID-19 infection in patients with MS in Colombia appears to be independent of clinical and treatment variables, and it appears to be associated with younger age.
Conclusions: More studies are needed to assess the behavior of COVID-19 in MS patients from Colombia.
References
Tur C, Dubessy A-L, Otero-Romero S, Amato MP, Derfuss T, Di Pauli F, et al. The risk of infections for multiple sclerosis and neuromyelitis optica spectrum disorder disease-modifying treatments: Eighth European Committee for Treatment and Research in Multiple Sclerosis Focused Workshop Review. Mult Scler. 2022;28:1424–56. https://doi.org/10.1177/13524585211069068
Louapre C, Collongues N, Stankoff B, Giannesini C, Papeix C, Bensa C, et al. Clinical Characteristics and Outcomes in Patients With Coronavirus Disease 2019 and Multiple Sclerosis. JAMA Neurol. 2020;77:1079. https://doi.org/10.1001/jamaneurol.2020.2581
Moreno-Torres I, Meca Lallana V, Costa-Frossard L, Oreja-Guevara C, Aguirre C, Alba Suárez EM, et al. Risk and outcomes of COVID-19 in patients with multiple sclerosis. Eur J Neurol. 2021;28:3712–21. https://doi.org/10.1111/ene.14990
Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. Journal of Infection. 2020;81:e16–25. https://doi.org/10.1016/j.jinf.2020.04.021
Bsteh G, Bitschnau C, Hegen H, Auer M, Di Pauli F, Rommer P, et al. Multiple sclerosis and COVID-19: how many are at risk? Eur J Neurol. 2021;28:3369-3374. https://doi.org/10.1111/ene.14555
Chaudhry F, Bulka H, Rathnam AS, Said OM, Lin J, Lorigan H, et al. COVID-19 in multiple sclerosis patients and risk factors for severe infection. J Neurol Sci. 2020;418:117147. https://doi.org/10.1016/j.jns.2020.117147
Zuluaga-Rodas M, Orozco-Gonzalez C, Ortiz-Salas P, Vagner B, Gortari J, Camacho-Barbosa J, et al. COVID-19 in patients with multiple sclerosis and neuromyelitis optica spectrum disorder in Colombia. Mult Scler J. 2021;27:235–6.
Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17:162–73. https://doi.org/10.1016/S1474-4422(17)30470-2
Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83:278–86. https://doi.org/10.1212/WNL.0000000000000560
Kurtzke J. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33:1444–52. https://doi.org/10.1212/wnl.33.11.1444
Laroni A, Schiavetti I, Sormani MP, Uccelli A. COVID-19 in patients with multiple sclerosis undergoing disease-modifying treatments. Mult Scler. 2021; 27:2126–36. https://doi.org/10.1177/1352458520971817
Hada M, Mosholder AD, Leishear K, Perez-Vilar S. Systematic review of risk of SARS-CoV-2 infection and severity of COVID-19 with therapies approved to treat multiple sclerosis. Neurol Sci. 2022;43:1557–67. https://doi.org/10.1007/s10072-021-05846-3
Sormani MP, De Rossi N, Schiavetti I, Carmisciano L, Cordioli C, Moiola L, et al. Disease?Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis. Ann Neurol. 2021;89:780–9. https://doi.org/10.1002/ana.26028
Sormani MP, Salvetti M, Labauge P, Schiavetti I, Zephir H, Carmisciano L, et al. DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France. Ann Clin Transl Neurol. 2021;8:1738–44. https://doi.org/10.1002/acn3.51408
Simpson-Yap S, De Brouwer E, Kalincik T, Rijke N, Hillert JA, Walton C, et al. Associations of Disease-Modifying Therapies With COVID-19 Severity in Multiple Sclerosis. Neurology. 2021;97:e1870–85. https://doi.org/10.1212/WNL.0000000000012753
Strangfeld A, Schäfer M, Gianfrancesco MA, Lawson-Tovey S, Liew JW, Ljung L, et al. Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis. 2021;80:930–42. https://doi.org/10.1136/annrheumdis-2020-219498
Vijenthira A, Gong I, Betschel SD, Cheung M, Hicks LK. Vaccine response following anti-CD20 therapy: a systematic review and meta-analysis of 905 patients. Blood Adv. 2021;5:2624–43. https://doi.org/10.1182/bloodadvances.2021004629
Apostolidis SA, Kakara M, Painter MM, Goel RR, Mathew D, Lenzi K, et al. Cellular and humoral immune responses following SARS-CoV-2 mRNA vaccination in patients with multiple sclerosis on anti-CD20 therapy. Nat Med. 2021; 27:1990–2001. https://doi.org/10.1038/s41591-021-01507-2
Sullivan R, Kilaru A, Hemmer B, Campbell Cree BA, Greenberg BM, Kundu U, et al. COVID-19 Infection in Fingolimod- or Siponimod-Treated Patients. Neurol - Neuroimmunol Neuroinflammation. 2022;9:e1092. https://doi.org/10.1212/NXI.0000000000001092
Meyer-Arndt L, Braun J, Fauchere F, Vanshylla K, Loyal L, Henze L, et al. SARS-CoV-2 mRNA vaccinations fail to elicit humoral and cellular immune responses in patients with multiple sclerosis receiving fingolimod. J Neurol Neurosurg Psychiatry. 2022;93:960–71. https://doi.org/10.1136/jnnp-2022-329395
Tortorella C, Aiello A, Gasperini C, Agrati C, Castilletti C, Ruggieri S, et al. Humoral- and T-Cell–Specific Immune Responses to SARS-CoV-2 mRNA Vaccination in Patients With MS Using Different Disease-Modifying Therapies. Neurology. 2022;98:e541–54. https://doi.org/10.1212/WNL.0000000000013108
Zabalza A, Arrambide G, Otero-Romero S, Pappolla A, Tagliani P, López-Maza S, et al. Is humoral and cellular response to SARS-CoV-2 vaccine modified by DMT in patients with multiple sclerosis and other autoimmune diseases? Mult Scler. 2022;28:1138-1145. https://doi.org/10.1177/13524585221089540
Saraceno L, Susani EL, Marazzi MR, Moioli MC, Agostoni EC, Protti A. SARS-CoV-2 infection after alemtuzumab in a multiple sclerosis patient: milder disease symptoms in comparison with coinfected relatives: a case report and review of the literature. Neurol Sci. 2021;42:4881–4. https://doi.org/10.1007/s10072-021-05567-7
Matías-Guiu J, Montero-Escribano P, Pytel V, Porta-Etessam J, Matias-Guiu JA. Potential COVID-19 infection in patients with severe multiple sclerosis treated with alemtuzumab. Mult Scler Relat Disord. 2020;44:102297. https://doi.org/10.1016/j.msard.2020.102297
Peckham H, de Gruijter NM, Raine C, Radziszewska A, Ciurtin C, Wedderburn LR, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun.2020;11: 6317. https://doi.org/10.1038/s41467-020-19741-6
Abate BB, Kassie AM, Kassaw MW, Aragie TG, Masresha SA. Sex difference in coronavirus disease (COVID-19): a systematic review and meta-analysis. BMJ Open. 2020;10:e040129. https://doi.org/10.1136/bmjopen-2020-040129
Scalfari A, Neuhaus A, Daumer M, Ebers GC, Muraro PA. Age and disability accumulation in multiple sclerosis. Neurology. 2011;77:1246–52. https://doi.org/10.1212/WNL.0b013e318230a17d

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

