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.

Details

Title
Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies — the Polish experience
Author
Czarnowska, Agata 1   VIAFID ORCID Logo  ; Brola, Waldemar 2   VIAFID ORCID Logo  ; Zajkowska, Olga 3   VIAFID ORCID Logo  ; Rusek, Stanisław 4 ; Adamczyk-Sowa, Monika 5 ; Kubicka-Bączyk, Katarzyna 5 ; Kalinowska-Łyszczarz, Alicja 6 ; Kania, Karolina 7 ; Słowik, Agnieszka 8 ; Wnuk, Marcin 8 ; Marona, Monika 8 ; Podlecka-Piętowska, Aleksandra 9 ; Nojszewska, Monika 9 ; Zakrzewska-Pniewska, Beata 9 ; Jasińska, Elżbieta 10 ; Gołuch, Katarzyna 11 ; Lech, Beata 12 ; Noga, Magdalena 12 ; Perenc, Adam 12 ; Popiel, Małgorzata 12 ; Lasek-Bal, Anetta 13 ; Puz, Przemysław 13 ; Maciejowska, Katarzyna 13 ; Kucharska-Lipowska, Marta 14 ; Lipowski, Michał 15 ; Kapica-Topczewska, Katarzyna 16 ; Chorąży, Monika 16 ; Tarasiuk, Joanna 16 ; Kochanowicz, Jan 16 ; Kulikowska, Joanna 16 ; Wawrzyniak, Sławomir 17 ; Niezgodzińska-Maciejek, Anna 17 ; Pokryszko-Dragan, Anna 18 ; Gruszka, Ewa 18 ; Budrewicz, Sławomir 18 ; Białek, Marta 19 ; Kurkowska-Jastrzębska, Iwona 20 ; Kurowska, Katarzyna 20 ; Stępień, Adam 21 ; Włodek, Agata 22 ; Ptasznik, Violetta 23 ; Pawełczyk, Małgorzata 24 ; Sobolewski, Piotr 25 ; Lejmel, Henryka 26 ; Strzalińska, Katarzyna 27 ; Maciejowski, Maciej 28 ; Tutaj, Andrzej 29 ; Zwiernik, Jacek 30 ; Litwin, Anna 29 ; Lewańczyk, Bożena 31 ; Paprocka, Izabela 31 ; Zwiernik, Beata 32 ; Pawlos, Aleksandra 33 ; Borysowicz, Andrzej 34 ; Narożnik, Anna 34 ; Michałowska, Anna 29 ; Nosek, Krzysztof 33 ; Fudala, Małgorzata 35 ; Milewska-Jędrzejczak, Marta 36 ; Kułakowska, Alina 16 ; Bartosik-Psujek, Halina 37 

1  Medical University of Białystok, Poland. [email protected] 
2  Collegium Medicum, Jan Kochanowski University, Kielce, Poland 
3  Faculty of Economic Sciences, University of Warsaw, Poland 
4  Department of Neurology, Specialist Hospital Ludwika Rydygiera in Krakow, Poland 
5  Department of Neurology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland 
6  Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poland 
7  Department of Neurology, Poznan University of Medical Sciences, Poland 
8  Department of Neurology, Jagiellonian University Medical College, Krakow, Poland 
9  Department of Neurology, Medical University of Warsaw, Poland 
10  Collegium Medicum UJK, and Clinical Center, RESMEDICA, Kielce, Poland 
11  Clinical Center, RESMEDICA, Kielce, Poland 
12  Neurology Clinic with Brain Stroke Sub-Unit, Clinical Hospital No. 2 in Rzeszow, Poland 
13  Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland 
14  Department of Neurology, Specialist Hospital in Końskie, Poland 
15  Department of Urology, Specialist Hospital in Końskie, Poland 
16  Medical University of Białystok, Poland 
17  Department of Neurology, 10th Military Research Hospital and Polyclinic, Independent Public Healthcare Centre, Bydgoszcz, Poland 
18  Department of Neurology, Wroclaw Medical University, Wroclaw, Poland 
19  Department of Neurology, Regional Specialised Hospital No. 4 in Bytom, Poland 
20  2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland 
21  Department of Neurology, Military Institute of Medicine, Warsaw, Poland 
22  Department of Neurology, Masovian Voivodeship Hospital in Siedlce, Poland 
23  Department of Neurology, Specialist Hospital in Pila, Poland 
24  Department of Neurology and Stroke, Medical University of Lodz, Poland 
25  Department of Neurology and Stroke Unit in Sandomierz, Collegium Medicum, Jan Kochanowski University in Kielce 
26  Department of Neurology, The Regional Hospital in Suwalki, Poland 
27  Department of Neurology, The Regional Hospital in Łomża, Poland 
28  KMK Clinical, MS Center, Katowice, Poland 
29  Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland 
30  Neurology Ward, Provincial Specialist Hospital, Olsztyn, Poland; Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland 
31  Neurology Ward, Provincial Integrated Hospital, Elbląg, Poland 
32  Department of Neurology, University of Warmia and Mazury, Olsztyn, Poland; Clinic of Neurology, University of Warmia and Mazury, Olsztyn, Poland 
33  Department of Pharmacology and Toxicology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland 
34  Department of Neurology, Specialist Hospital Dr Tytus Chałubiński Radom, Poland 
35  Department of Neurology, Regional Hospital in Skarżysko-Kamienna, Poland 
36  Department of Neurology and Ischemic Strokes, Medical University of Lodz, Poland 
37  Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Poland 
First page
212
End page
222
Publication year
2021
Publication date
2021
Publisher
Wydawnictwo Via Medica
ISSN
00283843
e-ISSN
18974260
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.5603/PJNNS.a2021.0031
ProQuest document ID
2692730760
Copyright
© 2021. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.