key: cord-0715014-r633pz6m
authors: Louapre, Céline; Maillart, Elisabeth; Roux, Thomas; Pourcher, Valérie; Bussone, Guillaume; Lubetzki, Catherine; Papeix, Caroline
title: Patients with MS treated with immunosuppressive agents: across the COVID-19 spectrum
date: 2020-04-27
journal: Rev Neurol (Paris)
DOI: 10.1016/j.neurol.2020.04.009
sha: 0ee42462912cae2b12b819a676e7fd1a83fabde2
doc_id: 715014
cord_uid: r633pz6m

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Multiple sclerosis (MS) related infections are frequent: urinary tract infections due to bladder and sphincter disorders, pulmonary infections linked to swallowing disorders or respiratory dysfunction. Currently, 15 immunomodulatory or immunosuppressive molecules are approved for MS treatment, some of them being associated with an increased infectious risk particularly progressive multifocal leukoencephalitis, herpes infections and pneumonia.

There is currently no data on the consequences of COVID-19 in patients with MS. Experts have proposed a stratification of the risk of MS treatments on COVID-19 1, 2 .

We report here 2 patients with MS, hospitalized because of MS and diagnosed with COVID-19 (Figure) . Many initiatives including national and international registries have emerged to collect epidemiological data from MS patients with COVID-19. These registries will make it possible to identify the demographic characteristics of MS patients with COVID-19, to compare them with those of the general population and to determine whether immunosuppressive treatments significantly influence the clinical expression and severity of COVID-19, among known risk factors such as age, neurological disability, hypertension, obesity and pulmonary diseases. Meanwhile, it seems reasonable to discuss treatment options individually, considering MS activity and known risk factors for severe COVID-19. National recommendations have been issued 8 and will be updated upon the results from epidemiological and immunological studies about COVID-19 in MS population.

Treating multiple sclerosis and neuromyelitis optica spectrum disorder during the COVID-19 pandemic

The COVID-19 pandemic and the use of MS Disease-Modifying Therapies. Multiple Sclerosis and Related Disorders

Ocrelizumab versus Placebo in Primary Progressive Multiple Sclerosis

Successful recovery of COVID-19 pneumonia in a renal transplant recipient with long-term immunosuppression

Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies

COVID-19 in post-transplantation patients-report of two cases

Clinical characteristics of COVID-19-infected cancer patients: A retrospective case study in three hospitals within Wuhan, China

All authors report no disclosure related to the present study.

Timeline for both patients: multiple sclerosis onset and succession of disease modifying therapies,