October 1, 2020
Update: COVID-19 in people with multiple sclerosis (MS)
A global data sharing initiative was established in response to the new coronavirus and a need for evidence to guide clinical management of MS during the pandemic. The initiative seeks to understand the risks of COVID-19 in people with MS and whether disease modifying therapies (DMTs) affect COVID-19 disease course or outcomes. This global initiative brings together clinician-reported data from 18 countries, including Canada. The North American COVID-19 & MS registry called COViMS is jointly supported by Consortium of MS Centers, National MS Society USA, and MS Society of Canada.
From an initial analysis of the global data, older age, progressive MS, higher disability (non-ambulatory status), chronic renal disease, and cardiovascular disease were risk factors for poorer outcomes. There was no clear associations found between a specific therapy and death when you adjust for the variables: age, sex, ambulatory status and comordities.. Anti-CD20 DMTs (such as ocrelizumab and rituximab) showed higher frequencies of hospital admission, ICU admission and need for artificial ventilation as compared to those on dimethyl fumarate (DMF).
The North American COVID-19 & MS registry (COViMS) looked at people with COVID-19 and MS in racialized groups (non-Hispanic White and Black/African American) to understand differences in health outcomes. COViMS reported 223 of the 858 cases as Black or African American. Black/African American cases were more likely to be younger, never cigarette smokers, have shorter MS disease duration as compared to Whites. A higher proportion of Black/African American cases had other conditions such as cerebrovascular disease, chronic lung disease, diabetes, hypertension and morbid obesity. The analysis indicated that Black/African American cases had increased risk of poorer outcomes (increased mortality, ICU admission, hospitalization) as compared to Whites even after adjusting for age, sex, MS disease characteristics, smoking and comorbidities at time of COVD-19 .
Data collection efforts are ongoing to continue to understand health outcomes, and this information will be used to update the COVID-19 global advice (link). Note that all COViMS data is shared and integrated with the global data sharing initiative and that all patient data collected for this initiative has been de-identified to maintain the privacy of individuals.