ISSN 2329-9835
International Journal of Diseases and Disorders ISSN 2329-9835 Vol. 11 (11), pp. 001-007, November, 2023. © International Scholars Journals
Full Length Research Paper
Clinical characteristics, re-infection, seropositivity and the role of Disease Modifying Drugs (DMDs) in COVID-19 infected MS and NMOSD patients: A 12 months prospective observational study
Seyed Massood Nabavi1,2, Shahedeh Karimi1,2, Monireh Samimi2, Leila Ghalichi2, Mehrnoosh Mehrabani2, Maryam Dastoorpour3, Sepideh Yazdanbakhsh2, Abbas Najafian2, Leyla Faghani2, Behzad Mansouri 4, Ashraf Zarvani5, MahtabAhmadipour1, Massoud Vosough1
1Department of Regenerative Medicine, Cell science research center, Royan institute for stem cell biology and technology, Tehran, Iran.
2Arya group for Treatment and Research in MS, Tehran, Iran.
3Department of Biostatistics and Epidemiology, Social Determinants of Health Research Center, Ahvaz Jundishapour University of Medical Science, Ahvaz, Iran.
4Brain, Vision and Concussion Clinic, Neuro-Ophthalmology iScope, Winnipeg, CA.
5Department of Neurology, Faculty of Medicine, Mazandaran University of Medical Science, Sari, Iran.
Abstract
Objectives: Multiple Sclerosis (MS) and Neuromyelitis Optica Spectrum Disorder (NMOSD) patients may have higher risk of contracting COVID-19 infection due to the medications, disability and other comorbidities leading to immune system dysfunction. COVID-19 may aggravate MS and NMOSD or lead to their progression. Methods: We investigated the clinical characteristics of COVID-19 infection and the relationship between using disease modifying drugs (DMDs) and other possible contributing factors with the rate and severity of COVID-19 infection in MS/NMOSD patients through a cohort as a longitudinal observational cross-sectional study. The sample was all MS and NMOSD patients those whom visited in a referral MS clinic in Tehran, Iran, and went through three-monthly follow-ups for 12 months. Patients were assessed for clinical symptoms, re-infection with COVID-19 and its seropositivity. Results: From the total 2878 patients, 2328 were under treatment with DMDs. In confirmed COVID-19 contracted patients (42), 12 patients used Rituximab, 6 Beta interferon, 3 Teriflunomide, 5 Natalizumab, 9 Fingolimod, 3 Dimethyl fumarate, one Azathioprine and 3 were no DMD using. Some patients treated with DMDs such as Rituximab, Fingolimod and Natalizumab were at a higher risk of COVID-19 infection or even re-infection compared to other DMDs. It is probable that some drugs could have relatively protective effects.We had limited report of exacerbation of MS and NMOSD among confirmed cases not close to the infection time, at least in our short-term follow-up. Conclusions: MS and NMOSD patients had no higher risk of contracting COVID-19 infection than general population. Some DMDs had a role in severity of infection or re-infection and also in the rate of seropositivity.
Key words: COVID-19, seropositivity, re-infection, multiple sclerosis, Neuromyelitis Optica Spectrum Disease.