B-cell depleting therapies may affect susceptibility to acute respiratory illness among patients with Multiple Sclerosis during the early COVID-19 epidemic in Iran
Open accessAbstract
Objective To determine whether the course of COVID-19 is more severe in patients with MS and if MS disease-modifying treatments (DMTs) affect the risk of contracting the disease.Methods In a cross-sectional survey, data were collected by sending a questionnaire to 2000 patients with a demyelinating disease through an online portal system. Collected data included the current MS DMT and patient-reported disability level, history of recent sick contact, recent fever, respiratory symptoms, diagnosis with COVID-19, and the disposition after the diagnosis. We defined a COVID-19-suspect group as patients having fever and cough or fever and shortness of breath, or a presumptive diagnosis based on suggestive chest computed tomography. We calculated the proportion of COVID-19-suspect patients and compared their demographics, clinical characteristics, and DMT categories with the rest of survey-responders, using univariable and multivariable models.Results Out of 712 patients, 34 (4.8%) fulfilled our criteria for being in the COVID-19-suspect group. Only two patients required hospitalization. No patient required intensive care. In a multivariable model, disease duration (p-value=0.017), DMT category (p-value=0.030), and history of sick contact (p-values<0.001) were associated with the risk of being in the COVID-19-suspect group. Being on B-cell depleting antibodies (as compared to non-cell depleting, non-cell trafficking inhibitor DMTs) was associated with a 2.6-fold increase in the risk of being in the COVID-19-suspect group. (RR: 3.55, 95%CI: 1.45, 8.68, p-value=0.005).Conclusions The course of infection in patients with MS suspected of having COVID-19 was mild to moderate, and all patients had a full recovery. B-cell depleting antibodies may increase the susceptibility to contracting COVID-19.
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Three studies totaling 31 COVID-19 cases in subjects on B cell depletion therapy reported all cases resolved without intensive care.
“Three studies, with a total of 31 COVID-19 cases, of subjects on B cell depletion therapy reported all COVID-19 cases resolved without intensive care (Montero-Escribano et al., 2020; Novi et al., 2020; Safavi et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Safavi et al., 2020
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- Authors
- Safavi, F., Nourbakhsh, B., & Azimi, A. R.
- Affiliations
- National Institutes of Health (US)
- Johns Hopkins University (US)
- Tehran University of Medical Sciences (IR)
- Corresponding author
- Azimi, Amir Reza
- Venue
- Multiple Sclerosis and Related Disorders
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 43
- Pages
- 102195
- ISSN
- 2211-0348 (ISSN-L)
- PMC
- PMC7219389
- OpenAlex
- W3024448878
- Cited by
- 140
- References
- 22
- Citations by year
- 2025: 3 · 2024: 7 · 2023: 12 · 2022: 34 · 2021: 49 · 2020: 34 · 2013: 1
- FWCI
- 21.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Multiple Sclerosis and Related Disorders (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- MS
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- multiple sclerosis, COVID-19 pandemic, B-cell depletion therapy, disease-modifying therapy, COVID-19 susceptibility, infection risk, demyelinating disease, disease duration
- MeSH terms
- Glatiramer Acetate, Fingolimod Hydrochloride, Rituximab, Natalizumab, Dimethyl Fumarate, Betacoronavirus, COVID-19, SARS-CoV-2, Adult, B-Lymphocytes, Cough, Cross-Sectional Studies, Crotonates, Disease Susceptibility, Dyspnea, Female, Fever, Hospitalization, Humans, Hydroxybutyrates, Immunologic Factors, Intensive Care Units, Interferons, Iran, Lung, Lymphocyte Depletion, Male, Multiple Sclerosis, Nitriles, Pneumonia, Viral, Severity of Illness Index, Toluidines, Tomography, X-Ray Computed, Immunocompromised Host, Coronavirus Infections, Multiple Sclerosis, Chronic Progressive, Multiple Sclerosis, Relapsing-Remitting, Epidemics, Pandemics, Antibodies, Monoclonal, Humanized
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