The Outcome of COVID-19 in Pediatric-Onset Multiple Sclerosis Patients

• Published in: Pediatric neurology Vol. 134; pp. 7 - 10
• Main Authors: Oncel, Ibrahim, Alici, Nurettin, Solmaz, Ismail, Oge, Dogan Dinc, Ozsurekci, Yasemin, Anlar, Banu
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2022
• Subjects: Adult; Child; COVID-19; COVID-19 - complications; Cross-Sectional Studies; Disease-modifying therapy; Humans; Multiple Sclerosis - complications; Multiple Sclerosis - drug therapy; Multiple Sclerosis - epidemiology; Pandemics; Pediatric-onset multiple sclerosis; Research Paper; SARS-CoV-2; Severity; COVID-19; Severity; Pediatric-onset multiple sclerosis; Disease-modifying therapy
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2022.06.004

The pathogenesis of multiple sclerosis (MS) involves immune-mediated mechanisms, and disease-modifying therapies (DMTs) administered in MS have immunomodulatory effects. The concern about MS patients' susceptibility to coronavirus disease 2019 (COVID-19) has prompted several studies based on clinical observations and questionnaires. Information about COVID-19 in pediatric-onset multiple sclerosis (POMS) is scarce. The objective of this study was to collect information on the experience of POMS patients with COVID-19 during the pandemic. This cross-sectional study was conducted with POMS patients diagnosed at Hacettepe University Pediatric Neurology Department and under 23 years of age between October 1 and December 31, 2021. Those who experienced COVID-19 or had a history of contact and were found seropositive for COVID-19 were evaluated for the severity of COVID-19, disability, treatment status, and comorbidities. Among the 101 POMS patients, 13 reported having had COVID-19 and five were exposed and seropositive but clinically asymptomatic. Of these 18 patients, 14 were ≤18 years of age at the time of the study. All 13 patients (72%) reported mild symptoms without hospitalization or respiratory support. Four of 18 had a neurological disability (Expanded Disability Status Scale [EDSS] scores ranging between 1 and 7.5), while the remaining had a score of 0. The outcome of COVID-19 was not affected by DMTs, neurological disabilities, and comorbidities. In this single-center POMS series, the small subgroup of patients who had contacted the SARS-CoV-2 virus or developed COVID-19 had reported no or mild symptoms. This may be partly related to the infrequent use of rituximab in this group. Our results corroborate those in adult-onset MS where no increased risk is reported for patients whose EDSS scores are <6 and who are not on B cell–depleting DMTs. Although less frequently than in adult MS, immunosuppressive DMTs may be needed in POMS; therefore, the importance of appropriate vaccination is to be underlined.