Happy CoVID Christmas

H

Zabalza A, Cárdenas-Robledo S, Tagliani P, Arrambide G, Otero-Romero S, Carbonell-Mirabent P, Rodriguez-Barranco M, Rodríguez-Acevedo B, Restrepo Vera JL, Resina-Salles M, Midaglia L, Vidal-Jordana A, Río J, Galan I, Castillo J, Cobo-Calvo Á, Comabella M, Nos C, Sastre-Garriga J, Tintore M, Montalban X. COVID-19 in MS patients: susceptibility, severity risk factors and serological response. Eur J Neurol. 2020 Dec 19. doi: 10.1111/ene.14690.

Background: Information regarding multiple sclerosis (MS) patients with COVID-19 is scarce (really). The study objective is 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 positive SARS-CoV-2 serologies according to disease modifying treatments (DMTs).

Methods: Retrospective study of an MS cohort analysing data collected between February and May 2020. Cases were identified through an email survey and clinical visits. We examined the relationship of demographic and MS characteristics with COVID-19 and of the DMTs with SARS-CoV-2 serostatus.

Results: We collected data from 48 suspected cases out of 758 valid respondents and from 45 COVID-19 cases identified through clinical visits. Incidence was 6.3%. Nineteen(20.3%) patients were hospitalized 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 5y:1.41[1.09-1.83]), and time on anti-CD20-treatment (OR per 2y: 3.48[1.44-8.45]) were independent factors for presenting COVID-19 and age (OR per 10y:2.71[1.13-6.53]) for a severe COVID-19. Out of the 79 (84.9%) with serological test, 45.6% generated antibodies, but only 17.6% of those on anti-CD20 therapies. Lymphopenia or immunoglobulins levels did not relate with COVID-19.

Conclusions: MS patients present similar incidence, risk factors, and outcomes for COVID-19 than 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 antibody response. Only age was related with severity.

So this study from Barcelona using a similar approach to Iranian studies find limited evidence that anti-CD20 increases the risk of COVID-19 . However it blunts serooconversion, how quick before the first COVID-19 result>

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MouseDoctor

4 comments

  • As this Christmas, alongside everything else, isn’t free of the C-word, this doesn’t seem an inappropriate place to reply with:

    🎄VERY MERRY CHRISTMAS/FESTIVE PERIOD TO EVERYONE ON THE BLOG, MOST ESPECIALLY THE BARTS TEAM TO WHOM WE ARE ETERNALLY INDEBTED!🌲

    THANK YOU ONCE AGAIN for another 12 months of keeping us all so informed.
    Thanks ProfG for remaining so connected, despite your own medical trauma.
    Thanks MD for making me enjoy laughs throughout the year.

  • Out of curiosity, why is this not good evidence that anti-CD20 increases COVID incidence? They mentioned “time on anti-CD20-treatment (OR per 2y: 3.48[1.44-8.45])” as a factor for COVID incidence. RE: the ocralizumab comment, is it just because few people have been on it for 2+ years?

    They did say that it wasn’t a factor for serious COVID, which is maybe what you were referring to? Potentially underpowered there?

    • Thanks I have had another read and changed wording abit, the statistics were not compelling.

      Re ocrelizumab yes perhaps it is because of timing, the Roche data would refute the claims. It is however clear that anti CD20 is the most obviously affected/affecing treatment

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