INTRODUCTION: The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland . A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs . Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited . MATERIALS AND
METHODS: This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres . Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021 . Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health .
RESULTS: There were 114 males (28.8 %) and 282 females (71.2 %). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9 %). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years . Most of the MS patients were treated with dimethyl fumarate (164; 41.41 %). Other DMTs were less frequently used: interferon beta (82; 20.70 %), glatiramer acetate (42; 10.60 %), natalizumab (35; 8.84 %), teriflunomide (25; 6.31 %), ocrelizumab (20; 5.05 %), fingolimod (16; 4.04), cladribine (5; 1.26 %), mitoxantrone (3; 0.76 %), ozanimod (3; 0.76 %), and alemtuzumab (1; 0.25 %). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3 %) died due to SARS-CoV-2 infection, and three (0.76 %) patients were treated with mechanical ventilation; 106 (26.8 %) patients had at least one comorbid condition . There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used .
CONCLUSIONS AND CLINICAL
IMPLICATIONS: Most MS patients included in this study had a favourable course of SARS-CoV-2 infection . The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population . Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs.