Case series/case reports (Indigo)
Information regarding patients with multiple sclerosis (MS) and COVID‐19 is scarce. The objective of this study was to describe the incidence and characteristics of MS patients with COVID‐19, to identify susceptibility and severity risk factors, and to assess the proportion of patients with positive SARS‐CoV‐2 serology, according to disease modifying treatments (DMTs). This was a retrospective study of an MS cohort analysing data collected between February and May 2020. Cases were identified through an email survey and clinical visits. The authors examined the relationship of demographic and MS characteristics with COVID‐19 and of the DMTs with SARS‐CoV‐2 serostatus. Data from 48 suspected cases out of 758 valid respondents and from 45 COVID‐19 cases identified through clinical visits were collected. Incidence of COVID-19 amongst MS patients was 6.3%. Nineteen (20.3%) patients were hospitalised and 2 (2.2%) died. Multivariable models determined that age (odds ratio per 10 years: 0.53 [95% CI, 0.34‐0.85]), contact with a confirmed case (OR:197.02 [56.36‐688.79]), residence in Barcelona (OR:2.23 [1.03‐4.80]), MS duration (OR per 5 years:1.41[1.09‐1.83]), and time on anti‐CD20‐treatment (OR per 2 years: 3.48[1.44‐8.45]) were independent factors for presenting with COVID‐19 and age (OR per 10 years:2.71 [1.13‐6.53]) for severe COVID‐19. Out of 79 patients (84.9%) with a positive test, 45.6% generated antibodies, but this only occurred in 17.6% of those on anti‐CD20 therapies. Lymphopenia or immunoglobulin levels were not associated with COVID‐19. The authors concluded that MS patients present with similar incidence, risk factors, and outcomes for COVID‐19 to the general population. Patients treated with an anti‐CD20 therapy for a longer period of time might be in a higher risk of COVID‐19 and less than 20% generate an antibody response. Furthermore, only age was related to severity.