October 28, 2021
COVID-19 in patients with neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD)
A North American COVID-19 & MS registry, COViMS was established in response to the new coronavirus in order to understand how people with multiple sclerosis (MS) and other allied diseases such as Neuromyelitis Optica Spectrum Disorders (NMOSD) and Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) fare following COVID-19, and to understand whether there are patient and disease characteristics associated with worse outcomes.
To-date, several risk factors associated with worse COVID-19 outcomes have been reported in people living with MS (refer here), however little data has been reported on how COVID-19 affects people with NMOSD and MOGAD. As of June 7, 2021, the COViMS registry recorded 77 people with NMOSD and COVID-19 and 20 people with MOGAD and COVID-19 that were analyzed to determine whether there are risk factors for worse outcomes.
An analysis of the data indicates that of those with NMOSD and COVID-19, 15.6% were hospitalized, 9.1% were admitted to ICU and/or ventilated, and 10.4% did not survive. The demographics of those with NMOSD and COVID-19 in the registry were mostly female (81.6%), average age of 48.1 years, average disease duration of 9.1 years, and a majority were fully ambulatory (75.7%). Many of those with NMOSD in the registry (62.2%) were taking the disease-modifying therapy, rituximab, while 9.5% were not taking any disease-modifying therapy. The high mortality rate and poorer outcomes were found in those with comorbidities (the simultaneous presence of other diseases or medical conditions). The most common comorbidities reported were hypertension (20.8%), diabetes (15.6%) and morbid obesity (14.3%). Comorbidities was identified as a key risk factor for worse COVID-19 outcomes in people with NMOSD.
Of those with MOGAD and COVID-19, they found that 10% were hospitalized and 15% were admitted to ICU and/or ventilated. There were no deaths reported in this small sample. The demographics of those with MOGAD and COVID-19 in the registry were mostly female (70%), average age of 40.6 years, one half identified as non-Hispanic White, average disease duration of 5.4 years, and most were fully ambulatory (84.2%). Almost half of those with MOGAD in the registry were taking the disease-modifying therapy, rituximab. While no deaths were reported and no risk factors could be identified between those hospitalized and non-hospitalized, it is important to note that observations were limited in this cohort based on the small sample size of those reporting COVID-19.
This research identified that those with NMOSD had an increased mortality rate from COVID-19 and that comorbidities were a significant risk factor for worse COVID-19 outcomes. The most common comorbidities with NMOSD were hypertension, diabetes, and morbid obesity, which have also been shown to increase risk of poor outcomes in the general population. While no demographic or disease-modifying therapy differences posed a significant risk factor in these groups, larger sample sizes in the future may help to identify additional risk factors. Minimizing risk of infection through public health measures and COVID-19 vaccination should be strongly considered, especially for those at high risk for worse outcomes.
Newsome SD, Cross AH, Fox RJ, Halper J, Kanellis P, Bebo B, Li D, Cutter GR, Rammohan KW, Salter A. COVID-19 in Patients With Neuromyelitis Optica Spectrum Disorders and Myelin Oligodendrocyte Glycoprotein Antibody Disease in North America: From the COViMS Registry. Neurology – Neuroimmunology & Neuroinflammation. 2021 Aug 24;8(5):e1057.
Access full publication in Neurology – Neuroimmunology & Neuroinflammation - here
COViMS registry is jointly supported by the Consortium of MS Centers, National MS Society USA, and MS Society of Canada.