Department of Medicine, Kuwait and Head Neurology Unit, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
Neurology Unit, Mubarak al Kabeer Hospital, Ministry of Health, Jabriya, Kuwait.
Med Princ Pract. 2023;32(2):143-148. doi: 10.1159/000530764. Epub 2023 May 3.
Disease-modifying therapies (DMTs) in multiple sclerosis (MS) may affect the course and outcome of COVID-19, but withholding them could permit disease activity. This study aimed to understand the course of COVID-19 in unvaccinated patients with MS on disease-modifying therapies.
This descriptive study examined the course of COVID-19 among infected patients with MS followed up at a large tertiary center in Kuwait between March 1, 2020, and March 1, 2021. All subjects were outpatients at the time of data collection.
We studied 51 patients with MS confirmed to be infected with SARS-CoV-2 using real-time polymerase chain reaction. Of these patients, 33/51 were female, median age was 35 years (IQR 27-39 years), median Expanded Disability Status Scale score was 1.5 (IQR zero-3), and 47/51 had RRMS. B-cell-depleting agents (ocrelizumab and rituximab) were given to 19 patients, another 19 were on immune cell traffickers (fingolimod and natalizumab), and 13 were on other DMT treatments (alemtuzumab, cladribine, interferon-beta, dimethyl fumarate, and teriflunomide). 43/51 of these patients experienced mild COVID-19, not requiring hospitalization. None of the subjects experienced MS relapses during infection. Two patients on rituximab had a moderate course of the illness, which required hospitalization for oxygen support, but did not need mechanical ventilation; the rest of the subjects remained asymptomatic.
These findings suggest that DMT may not adversely affect the course of COVID-19 in MS patients; however, patients on B-cell-depleting agents trended toward a worse outcome.
多发性硬化症（MS）中的疾病修正疗法（DMT）可能会影响 COVID-19 的病程和结局，但如果不使用这些疗法，可能会导致疾病活动。本研究旨在了解未接种疫苗的 MS 患者在接受疾病修正治疗时 COVID-19 的病程。
本描述性研究调查了 2020 年 3 月 1 日至 2021 年 3 月 1 日期间在科威特一家大型三级中心接受治疗的感染 MS 患者的 COVID-19 病程。所有患者在收集数据时均为门诊患者。
我们研究了 51 例经实时聚合酶链反应证实感染 SARS-CoV-2 的 MS 患者。这些患者中，33/51 例为女性，中位年龄为 35 岁（IQR 27-39 岁），中位扩展残疾状况量表评分 1.5（IQR 0-3），47/51 例为 RRMS。19 例患者使用 B 细胞耗竭剂（奥瑞珠单抗和利妥昔单抗），19 例患者使用免疫细胞转运蛋白（芬戈莫德和那他珠单抗），13 例患者使用其他 DMT 治疗（阿仑单抗、克拉屈滨、干扰素-β、富马酸二甲酯和特立氟胺）。51 例患者中有 43 例患有轻度 COVID-19，无需住院治疗。在感染期间，没有患者发生 MS 复发。2 例使用利妥昔单抗的患者病情中度，需要住院吸氧支持，但无需机械通气；其余患者无症状。
这些发现表明 DMT 可能不会对 MS 患者 COVID-19 的病程产生不利影响；然而，使用 B 细胞耗竭剂的患者病情趋于恶化。
