SARS-CoV-2 infection among patients with multiple sclerosis; A cross-sectional study

  1. Mahnaz Bayat
  2. Alireza Fayyazpoor
  3. Afshin Borhani Haghighi
  4. Daniyal Salehi
  5. Hossein Molavi Vardanjan
  6. Maryam Poursadeghfard

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Abstract

Background

Neurological disability associated with multiple sclerosis and immunosuppressive or immunomodulatory therapy which is administered for it may increases the risk of SARS-CoV-2 infection and its morbidity/mortality.

Objective

In this study, we evaluated the infection rate and the severity of SARS-CoV-2 infection in patients with multiple sclerosis (MS)

Methods

One thousand and three hundred and sixty one MS patients from Fars province, south of Iran, were interviewed by phone from April 3 to June 20, 2020. Basic demographic data, information about MS disease and any symptoms or laboratory results relevant to COVID-19 were gathered and reviewed by treating neurologist and MS nurses. SPSS version 22 was used for data analysis.

Results

68 (5%) of MS patients were suspected cases and 8 (0.58%) of all patients with positive real-time reverse transcription polymerase chain reaction (RT-PCR) or chest CT were in the confirmed group. 5 cases of the confirmed group needed hospitalization. Two patients died while both of them had PPMS and were taking rituximab. The frequency rate of suspected cases with RRMS was 57 (87.7%), followed by PPMS 5 (7.7%) and CIS 2(3.1%). In the confirmed group 37.5% had RRMS, 50% had PPMS, 25% use corticosteroid drug, and 50% were on rituximab. 62.5% of confirmed cases had high disability level and need assistance to walk. 36.8% of suspected and 25% of the confirmed cases were on IFN-β1; eventually all of them recovered well from COVID-19 infection.

Conclusion

The present study showed that rate of developing COVID-19 in MS patients are similar to the general population and the frequency of PPMS phenotype, rituximab therapy and corticosteroid therapy were higher in the confirmed group.

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  1. ScreenIT

    SciScore for 10.1101/2020.10.17.20214429: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This Cross-Sectional Study was approved by Iran National Committee for Ethics in Biomedical Research with the registration number IR.SUMS.REC.1399.26. 1700 patients were contacted by phone from April 3 to June 20, 2020 and 1361 patients agreed to participate in our study.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical package for social sciences (SPSS Inc., Chicago, IL, USA) version 22 was used for data analysis.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and Limitations: This study was performed in the first pandemic wave with a large sample size in non-hospitalized MS patients which is a better indicator of the society. However, it has some limitations such as (a) provision the medical information of patients by phone is caused the possibility of intentional or inadvertent errors, (b) over or underestimations of suspected cases due to lack of PCR testing for COVID-19 infection in all of suspected patients or who have had symptoms for more than two weeks, and (c) impossibility of estimating the Expanded Disability Status Scale (EDSS) over the phone.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.10.17.20214429v1 on medRxiv