Risk of COVID-19 not increased in MS patients

Results of the largest community-based study of COVID-19 in MS worldwide suggest that people with MS are not more susceptible to SARS-CoV-2 infection than the UK general population [1]. During lockdown, with strict physical distancing measures, disease-modifying treatment (DMT) use or physical disability did not increase the likelihood of contracting COVID-19 nor affected recovery from COVID-19.

Participants of the United Kingdom MS Register (UKMSR) were asked to answer a COVID-19-related survey at admission and a follow-up survey every 2 weeks, depending on whether they reported COVID-19. The mean age of the 5,309 participants was 52.4 years, 76.1% were female. The overall incidence of self-diagnosed COVID-19 in this cohort was 535 (10.1%). In a time when testing facilities were still very limited, 75 of these 535 COVID-19 cases were confirmed by RT-PCR test. The COVID-19 incidence in this cohort peaked during the second week after lockdown started on 23 March 2020 (13.2%) and dropped to 3.5% in the 10^th week. Almost half of the MS patients (47%) went into self-isolation during lockdown (23 March–23 June 2020).

The strongest predictor for self-isolation was higher web-based EDSS score (OR 1.389; 95% CI 1.333-1.447). Other predictors were having progressive MS and using monoclonal antibodies or fingolimod as DMT. Older age (OR 0.969; 95% CI 0.957−0.982) and having progressive MS (OR 0.595, 95% CI 0.422−0.838) lowered the risk of COVID-19. This was not surprising, as these populations were more likely to self-isolate. MS duration nor physical disability altered the risk of contracting COVID-19. A multi-variate analysis is required to more accurately predict clinical and demographic risk factors. There was no DMT that was associated with an elevated risk of COVID-19 (see Figure). Of 336 COVID-19 patients of whom data on disease course was available, 249 (74.1%) recovered. The preliminary findings of this study did not show an association between faster recovery and MS-related factors, including EDSS score or DMT use.

Figure: Odds ratios of contracting COVID-19 while on DMT versus no DMT [1]

1. Garjani A, et al. COVID-19 in people with MS: A large community-based study of the UK MS Register. MSVirtual 2020, Abstract SS02.01.