简介：关于多发性硬化症（MS）患者2019年冠状病毒病（COVID-19）病程的数据有限。需要更多的实际数据来帮助MS社区正确管理MS治疗。特别是,重要的是要了解用于治疗MS的免疫抑制疗法对COVID-19预后的影响。方法：我们回顾性收集了接受奥克瑞珠单抗治疗的MS患者中所有确诊的COVID-19病例的数据，接下来是2020年2月至2021年6月在意大利北部大学医院的两个MS中心。结果：我们确定了15例接受奥利珠单抗治疗并确诊为COVID-19的MS患者(平均年龄，50.47±9.1年；EDSS中位数，3.0；范围1.0-7.0）。其中,14例通过鼻拭子确认，1例通过血清学测试确认。大多数患者的COVID-19严重程度为轻度至中度(n=11，73.3%；平均年龄，49.73；EDSS中位数3.0）。四名患者（26.7%；平均年龄，52.5年；EDSS中位数，6）患有严重疾病并住院；其中一人死亡（年龄50岁，EDSS6.0，无其他合并症）。他们都没有潜在的呼吸道合并症。结论：本病例系列突出了奥克瑞珠单抗治疗的MS患者COVID-19病程的巨大变异性。在COVID-19大流行的早期阶段，医疗保健系统遇到的挑战可能是导致本系列中观察到的病死率的原因。较高的MS相关残疾与更严重的COVID-19病程相关。
Introduction: Limited data are available on the course of Coronavirus disease 2019 (COVID-19) in people with Multiple Sclerosis (MS). More real-world data are needed to help the MS community to manage MS treatment properly. In particular, it is important to understand the impact of immunosuppressive therapies used to treat MS on the outcome of COVID-19. Methods: We retrospectively collected data on all confirmed cases of COVID-19 in MS patients treated with ocrelizumab, followed in two MS Centers based in University Hospitals in Northern Italy from February 2020 to June 2021. Results: We identified 15 MS patients treated with ocrelizumab with confirmed COVID-19 (mean age, 50.47 ± 9.1 years; median EDSS, 3.0; range 1.0-7.0). Of these, 14 were confirmed by nasal swab and 1 was confirmed by a serological test. COVID-19 severity was mild to moderate in the majority of patients (n = 11, 73.3%; mean age, 49.73; median EDSS 3.0). Four patients (26.7%; mean age, 52.5 years; median EDSS, 6) had severe disease and were hospitalized; one of them died (age 50, EDSS 6.0, no other comorbidities). None of them had underlying respiratory comorbidities. Conclusion: This
case series highlights the large variability of the course of COVID-19 in ocrelizumab-treated MS patients. The challenges encountered by the healthcare system in the early phase of the COVID-19 pandemic might have contributed to the
case fatality ratio observed in this series. Higher MS-related disability was associated with a more severe COVID-19 course.
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