MSCOVID19 week Isn’t this every week:-(

M

As there isnt a post today yet have this something new in the ether

Bsteh G, et al. COVID-19 severity and mortality in multiple sclerosis are not associated with immunotherapy: Insights from a nation-wide Austrian registry. PLoS One. 2021;16(7):e0255316. 

Background: The COVID-19 pandemic challenges neurologists in counselling patients with multiple sclerosis (pwMS) regarding their risk by SARS-CoV-2 and in guiding disease-modifying treatment (DMT).

Objective: To characterize the prevalence and outcome of COVID-19 in pwMS specifically associated with different DMT in a nationwide population-based study.

Methods: We included patients aged ≥18 years with a confirmed diagnosis of MS and a diagnosis of COVID-19 established between January 1, 2020 and December 31, 2020. We classified COVID-19 course as either mild, severe or fatal. Impact of DMT and specifically immunosuppressants (alemtuzumab, cladribine, fingolimod, ocrelizumab or rituximab) on COVID-19 outcome was determined by multivariable models, adjusted for a-priori-risk.

Results: Of 126 MS patients with COVID-19 (mean age 43.2 years [SD 13.4], 71% female), 86.5% had a mild course, 9.5% a severe course and 3.2% died from COVID-19. A-priori-risk significantly predicted COVID-19 severity (R2 0.814; p<0.001) and mortality (R2 0.664; p<0.001). Adjusting for this a-priori-risk, neither exposure to any DMT nor exposure to specific immunosuppressive DMT were significantly associated with COVID-19 severity (odds ratio [OR] 1.6; p = 0.667 and OR 1.9; p = 0.426) or mortality (OR 0.5; p = 0.711 and 2.1; 0.233) when compared to no DMT.

Conclusions: In a population-based MS cohort, COVID-19 outcome was not associated with exposure to DMT and immunosuppressive DMT when accounting for other already known risk factors. This provides reassuring evidence that COVID-19 risk can be individually anticipated in MS and-except for a very small proportion of high-risk patients-treatment decisions should be primarily focused on treating MS rather than the pandemic

You ask what so I think of this ….well I don’t much, we know the risks of MS-DMT are small and this supports previous studies by the french groups etc. However the group sizes are small and the number of people taking anti-CD20 is rather small i.e. less than 20 and so can’t make a call.

Simpson-Yap et al. Associations of DMT therapies with COVID-19 severity in multiple sclerosis. MedRXiv https://doi.org/10.1101/2021.02.08.21251316 (n= 2,360)

This says something is happening based on more people

Fragoso YD, Schiavetti I, Carmisciano L, Ponzano M, Steinberg J, Treviño-Frenk I, Ciampi E, Vecino MCA, Correa EP, Carcamo C, Gomes S, Pimentel MLV, Santos GAC, Vrech C, Winckler TCA, Sormani MP. Coronavirus disease 2019 in Latin American patients with multiple sclerosis. Mult Scler Relat Disord. 2021 Jul 25;55:103173. doi: 10.1016/j.msard.2021.103173

Patients with multiple sclerosis (MS) who present coronavirus disease 2019 (COVID-19) are of particular interest to neurologists. These patients have a neuroimmune disease and receive immunomodulatory or immunosuppressive therapies in the long-term. We present here data from 73 patients with MS and a confirmed diagnosis of COVID-19 from five Latin American countries. Fifteen patients (20.5%) were hospitalized and two patients died. The use of anti-CD20 therapies was the only risk factor associated to hospitalization and death. Despite the small sample size, this study highlights the awareness regarding therapeutic options for MS during the pandemic.

We all know that during lockdown it was SH1 this says it was SH1 for people with MS too..no SH1 sherlock:-(

Sahin S, Karsidag S, Cinar N, Ates MF, Demir S, Eren F, Neyal A, Kisabay Ak A, Bora Tokcaer A, Erkoc Ataoglu E, Akkaya SN, Aciman Demirel E, Koc F, Ozturk S, Ekmekyapar Firat Y, Okluoglu T, Togrol E, Erdemoglu AK, Ergin N, Sayin R, Demir A, Yilmaz SE. The Impact of the COVID-19 Lockdown on the Quality of Life in Chronic Neurological Diseases: The Results of a COVQoL-CND Study. Eur Neurol. 2021 Aug 3:1-10. doi: 10.1159/000517380. Epub ahead of print. PMID: 34344010.

Background: Coronavirus disease 2019 (COVID-19) pandemic and lockdown period may induce an impairment in quality of life (QoL), disruption in treatment (DIT), and posttraumatic stress disorder (PTSD) in chronic neurological diseases (CNDs). To reach this information, a multicenter, cross-sectional study (COVQoL-CND) was planned. Parkinson’s disease (PD), headache (HA), multiple sclerosis (MS), epilepsy (EP), polyneuropathy (PNP), and cerebrovascular disease (CVD) were selected as the CND.

Methods: The COVQoL-CND study includes demographic data, the World Health Organization Quality of Life short form (WHOQOL-BREF), and Impact of Event Scale-Revised (IES-R) forms.

Results: The mean age of a total of 577 patients was 49 ± 17 (19-87 years), and the ratio of female/male was 352/225. The mean age of patients with PD, HA, MS, EP, PNP, and CVD were 65 ± 11, 39 ± 12, 38 ± 10, 47 ± 17, 61 ± 12, and 60 ± 15 years, respectively. The IES-R scores were found to be higher in the younger group, those with comorbid disease, contacted with CO-VID-19 patients, or diagnosed with COVID-19. In the group with a high IES-R score, the rate of DIT was found to be high. IES-R scores were negatively correlated with QoL. IES-R total scores were found highest in the CVD group and lowest in the PD group. The ratio of DIT was found highest in the PNP group and the lowest in the EP group. Contact with CO-VID-19 patients was high in the EP and HA group.

Conclusions: The results of the COVQoL-CND study showed that lockdown causes posttraumatic stress and deterioration in the QoL in CND.

Apologises if I have posted rhis one already

Sormani MP, Schiavetti I, Landi D, Carmisciano L, De Rossi N, Cordioli C, Moiola L, Radaelli M, Immovilli P, Capobianco M, Brescia Morra V, Trojano M, Tedeschi G, Comi G, Battaglia MA, Patti F, Fragoso YD, Sen S, Siva A, Furlan R, Salvetti M. SARS-CoV-2 serology after COVID-19 in multiple sclerosis: An international cohort study. Mult Scler. 2021 Jul 30:13524585211035318. doi: 10.1177/13524585211035318.

Background: The MuSC-19 project is an Italian cohort study open to international partners that collects data on multiple sclerosis (MS) patients with COVID-19. During the second wave of the pandemic, serological tests became routinely available.

Objective: To evaluate the seroprevalence of anti-SARS-CoV-2 antibodies according to the use of disease-modifying therapy (DMT) in a subset of patients included in the MuSC-19 data set who had undergone a serological test.

Methods: We evaluated the association between positive serological test results and time elapsed since infection onset, age, sex, Expanded Disability Status Scale score, comorbidities and DMT exposure using a multivariable logistic model.

Results: Data were collected from 423 patients (345 from Italy, 61 from Turkey and 17 from Brazil) with a serological test performed during follow-up. Overall, 325 out of 423 tested patients (76.8%) had a positive serological test. At multivariate analysis, therapy with anti-CD20 was significantly associated with a reduced probability of developing antibodies after COVID-19 (odds ratio (OR) = 0.20, p = 0.002)= reduced by 80%

Conclusion: Patients with MS maintain the capacity to develop humoral immune response against SARS-COV-2, although to a lesser extent when treated with anti-CD20 drugs. Overall, our results are reassuring with respect to the possibility to achieve sufficient immunization with vaccination.

General Disclaimer: Please note that the opinions expressed here are those of authors and do not necessarily reflect the positions of the Barts and The London School of Medicine and Dentistry nor Barts Health NHS Trust and are not meant to be interpreted as personal clinical advice. Disclaimer:

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MouseDoctor

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  • I remember people were commenting here a year ago that neurologists were refusing to give them DMTs because of COVID… What a disaster.

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