COViMS Registry Collects Data On Patients With MS And COVID-19

By Erik Greb

More than 4 months after it was established, the COViMS (COVID-19 Infections in Multiple Sclerosis and Related Diseases) database includes information about nearly 900 patients. The Consortium of Multiple Sclerosis Centers (CMSC) and the National Multiple Sclerosis Society (NMSS) initiated the database in April to gather information about COVID-19 infections and outcomes in North American patients with multiple sclerosis (MS) and other CNS demyelinating disorders. Although the data are beginning to clarify how the novel coronavirus affects this population of patients, CMSC and NMSS do not recommend that neurologists base clinical decisions on these data.

More than 150 North American clinics have contributed to COViMS. “It has been wonderful to see all of the providers take the time to input these cases so we can learn as much as possible about COVID-19 and MS,” said Amber Salter, PhD, a principal investigator for the COViMS registry and an assistant professor of biostatistics at Washington University School of Medicine in Saint Louis. Dr. Salter and the COViMS group are collaborating in the global data-sharing initiative begun by the MS International Federation and MS Data Alliance.

Dr. Amber Salter

Outcomes in MS and in the general population

The data so far indicate that outcomes in patients with MS who contract the novel coronavirus largely are consistent with those of the general population, said Dr. Salter. For example, the rate of reported mortality is lower now than it was in the early stages of the pandemic. Because the numbers of patients with neuromyelitis optica spectrum disorder (NMOSD) or other CNS demyelinating disorders are low, it is difficult to compare their outcomes with those of patients with MS, said Dr. Salter.

The numbers are continually being updated. As of August 18, the COViMS database includes 863 cases. This population includes 823 patients with confirmed MS, 22 patients with NMOSD, 8 patients with clinically isolated syndrome, 6 patients with radiologically isolated syndrome, and 4 patients with a myelin oligodendrocyte glycoprotein antibody disorder.

A total of 674 patients have laboratory positive COVID-19, and 189 have suspected but unconfirmed COVID-19. Of these patients, 540 have recovered, 190 are recovering, 50 have died, 31 never developed symptoms, and the status of 30 is currently unknown.

Comparing survivors and deceased patients

The COViMS website also compares patients who have died with those who have survived. More than 90% of patients overall are from the United States. The proportions of female patients are 60% among deceased patients and 73% among survivors. Mean ages are 62.8 years among deceased patients and 47.3 years among survivors. Mean disease durations are 20.8 years among deceased patients and 13.0 years among survivors.

The proportions of patients with confirmed MS are 94% among deceased patients and 95.4% among survivors. The most common disorder among the remainder of patients is NMOSD (6% of deceased patients and 2.4% of survivors). The clinical course of MS differed between deceased patients and survivors. Among deceased patients, 46.3% had secondary progressive MS, 34.1% had relapsing-remitting MS, and 17.1% had primary progressive MS. Among survivors, 79.3% had relapsing-remitting MS, 14.3% had secondary progressive MS, and 4.7% had primary progressive MS.

Approximately 16% of deceased patients were fully ambulatory, compared with 75% of survivors. Furthermore, 59.1% of deceased patients were nonambulatory, compared with 9% of survivors. Most (63.9%) deceased patients were not taking any disease-modifying therapy (DMT), while 22.2% of survivors take no DMT. The most common DMTs among deceased patients were ocrelizumab (11.1%) and rituximab (6.9%). Among survivors, the most common DMTs were ocrelizumab (29.0%), dimethyl fumarate (10.5%), and natalizumab (10.3%).

Comorbidities differ between deceased patients and survivors as well. Approximately 86% of deceased patients had comorbidities, compared with 47.6% of survivors. Among deceased patients, the most common comorbidities were hypertension (52%), cardiovascular disease (32%), and diabetes (20%). The most common comorbidities among survivors are hypertension (21.1%), morbid obesity (11.3%), and diabetes (8.6%).

“We plan to report information on factors such as [the effect of] demographics, comorbidities, and DMT on outcomes in patients with MS at the MSVirtual2020 conference in September,” Dr. Salter concluded.