Manifestations and impact of the COVID-19 pandemic in neuroinflammatory diseases

Objective: To report initial results of a planned multicenter year-long prospective study examining the risk and impact of COVID-19 among persons with neuroinflammatory disorders (NID), particularly multiple sclerosis (MS). Methods: In April 2020, we deployed online questionnaires to individuals in their home environment to assess the prevalence and potential risk factors of suspected COVID-19 in persons with NID (PwNID) and change in their neurological care. Results: Our cohort included 1115 participants (630 NID, 98% MS; 485 reference) as of 30 April 2020. 202 (18%) participants, residing in areas with high COVID-19 case prevalence, met the April 2020 CDC symptom criteria for suspected COVID-19, but only 4% of all participants received testing given testing shortages. Among all participants, those with suspected COVID-19 were younger, more racially diverse, and reported more depression and liver disease. PwNID had the same rate of suspected COVID-19 as the reference group. Early changes in disease management included telemedicine visits in 21% and treatment changes in 9% of PwNID. After adjusting for potential confounders, increasing neurological disability was associated with a greater likelihood of suspected COVID-19 (ORadj = 1.45, 1.17-1.84). Interpretations: Our study of real-time, patient-reported experience during the COVID-19 pandemic complements physician-reported MS case registries which capture an excess of severe cases. Overall, PwNID seem to have a risk of suspected COVID-19 similar to the reference population.

Automated summary

The initial results of the planned multicenter study on the risk and impact of COVID-19 among individuals with neuroinflammatory disorders, particularly multiple sclerosis, showed that those with suspected COVID-19 were younger, more racially diverse, and reported more health issues like depression and liver disease. However, persons with neuroinflammatory disorders had a similar rate of suspected COVID-19 as the reference group. Early changes in disease management included telemedicine visits and treatment changes in a small percentage of participants.