Patient Registry Offers Clearer Picture of How People With MS Respond to COVID-19

COViMS represents a collaboration between the CMSC, the Multiple Sclerosis Society of Canada, and the National Multiple Sclerosis Society. The goal of the registry is to collect data on the impact of COVID-19 in people with MS to better inform management decisions. Clinicians may enter data or find out more on www.COVIMS.org.ORLANDO, Fla. – It was not long into the COVID-19 pandemic before people with multiple sclerosis (MS) began to wonder how their altered immune status might affect their risks for contracting COVID or developing a more severe course if infected. Anne Cross, MD, Chair of Neuroimmunology at Washington University in St. Louis, was instrumental in starting the COViMS Registry. The registry’s goal is to collect data on outcomes from people with MS who develop confirmed COVID cases to help MS care professionals better guide patients and make treatment decisions.

The registry was designed to be easy and efficient for clinicians to enter case reports (less than 10 minutes) and to answer two basic questions:

• How do patients with MS fare after contracting COVID-19?
• How do individual disease-modifying therapies (DMTs) affect outcomes?

In April 2021, a third question was added:

• Are the patients vaccinated or unvaccinated against COVID-19?

At Tuesday’s session, “Viral Infections, What Have We Learned from COVID-19?” Dr. Cross presented what the registry has taught us about COVID and MS. As of October 5, 2021, there were 3,452 cases of COVID entered into the registry. Among these, 75% were female, 82% had relapsing-remitting MS, and 78% were fully ambulatory. As of October 5, about 41% were vaccinated, 42% were unvaccinated, and 17% had unknown vaccination status.

“Not surprisingly, age and male sex were associated with a worse prognosis from COVID,” Dr. Cross said. “The COViMS registry showed that, for every 10 years of years of age and taking comorbidities and other factors into account, the risk of death was 87.5% higher if you were 10 years older. In addition, males had a 2.2 times higher risk of dying than females, after adjusting for other variables.” Reported deaths (currently at 88) were consistent with rates in the general population, Dr. Cross noted. There were some disparate outcomes for Black patients in terms of increased risk for COVID hospitalizations and need for intensive care or a ventilator, but not an increased mortality rate.

When the question was reversed—how does COVID affect MS—Dr. Cross confirmed that the viral infection does not appear to affect MS disease course. There does not appear to be an increase in relapse risk due to COVID or vaccination, although some small studies have shown elevated rates of pseudoexacerbation, she reported.

One of the interesting questions arising from the DMT data was why such a high proportion of patients who contracted COVID were on ocrelizumab (30% of cases, while the next highest category was no DMT at 15.4% of cases). More study is needed to determine the effects of B-cell depleting therapies like ocrelizumab and rituximab on COVID risk and outcomes.

In general, COViMS findings were consistent with other registries of COVID and MS that are collecting data internationally, including Dutch, UK, Italian, and French databases, Dr. Cross said. For more information or to enter patient data, clinicians can access the registry site at www.COVIMS.org.