From the NYU Langone Multiple Sclerosis Comprehensive Care Centers (E.P., I.K., L.C., C.S., V.S., R.E.C., J.H., J.M.G., M.G., N.A.-F., R.W., M.K., L.B.K., L.Z.R.), New York, NY; and Cohen's Children Medical Center Northwell Health (C.F.-C.), Lake Success, NY.
Neurol Neuroimmunol Neuroinflamm. 2020 Jul 9;7(5). doi: 10.1212/NXI.0000000000000835. Print 2020 Sep.
To report outcomes on patients with multiple sclerosis (MS) and related disorders with coronavirus disease 2019 (COVID-19) illness.
From March 16 to April 30, 2020, patients with MS or related disorders at NYU Langone MS Comprehensive Care Center were identified with laboratory-confirmed or suspected COVID-19. The diagnosis was established using a standardized questionnaire or by review of in-patient hospital records.
We identified 76 patients (55 with relapsing MS, of which 9 had pediatric onset; 17 with progressive MS; and 4 with related disorders). Thirty-seven underwent PCR testing and were confirmed positive. Of the entire group, 64 (84%) patients were on disease-modifying therapy (DMT) including anti-CD20 therapies (n = 34, 44.7%) and sphingosine-1-phosphate receptor modulators (n = 10, 13.5%). The most common COVID-19 symptoms were fever and cough, but 21.1% of patients had neurologic symptom recrudescence preceding or coinciding with the infection. A total of 18 (23.7%) were hospitalized; 8 (10.5%) had COVID-19 critical illness or related death. Features more common among those hospitalized or with critical illness or death were older age, presence of comorbidities, progressive disease, and a nonambulatory status. No DMT class was associated with an increased risk of hospitalization or fatal outcome.
Most patients with MS with COVID-19 do not require hospitalization despite being on DMTs. Factors associated with critical illness were similar to the general at-risk patient population. DMT use did not emerge as a predictor of poor COVID-19 outcome in this preliminary sample.
报告伴有 2019 冠状病毒病（COVID-19）疾病的多发性硬化症（MS）和相关疾病患者的结局。
2020 年 3 月 16 日至 4 月 30 日，在纽约大学朗格尼医学中心 MS 综合护理中心确定了实验室确诊或疑似 COVID-19 的 MS 或相关疾病患者。通过标准化问卷或住院病历回顾建立诊断。
我们确定了 76 名患者（55 名复发性 MS，其中 9 名儿童发病；17 名进行性 MS；4 名相关疾病）。37 名患者接受了 PCR 检测，结果呈阳性。在整个组中，64 名（84%）患者正在接受疾病修正疗法（DMT），包括抗 CD20 疗法（n=34，44.7%）和鞘氨醇-1-磷酸受体调节剂（n=10，13.5%）。最常见的 COVID-19 症状是发热和咳嗽，但 21.1%的患者在感染前或同时出现神经症状复发。共有 18 名（23.7%）住院；8 名（10.5%）患者患有 COVID-19 危重症或相关死亡。在住院或患有危重症或死亡的患者中更常见的特征是年龄较大、合并症、进行性疾病和非活动性状态。没有 DMT 类别与住院或死亡的风险增加相关。
尽管正在接受 DMT，但大多数患有 COVID-19 的 MS 患者无需住院治疗。与危重症相关的因素与一般高危患者人群相似。在这个初步样本中，DMT 的使用并未成为 COVID-19 不良结局的预测因素。
