Epidemiology of COVID-19 among MS population: Population-based registry study in Iran

Introduction: Iran is one of the countries with high prevalence of multiple sclerosis (MS) and COVID-19 infection. 2,691,352 patients with COVID- 19 have been identified including 75,568 deaths in Iran until May 12, 2021. Objectives: To determine Epidemiology and the risk of COVID- 19 infection among MS patients in Iran. Methods: The nationwide MS registry of Iran (NMSRI) has set up a COVID-19 infection program in 9 provinces of Iran in 2020. All MS cases with confirmed diagnosis of Covid-19 infection were registered in NMSRI. This system, registering baseline characteristics, clinical presentations and symptoms, diagnostic and treatments, hospital course and outcomes, identification the risk factors that develop Covid-19 infection and improving quality of care among MS patients in regional and national level. The neurologist registers new events into the dataset including demographic characteristics, definite diagnosis of COVID-19 and its symptoms, history of comorbidities, history of hospitalization, Changes in MRI and infection outcomes. Results: A total number of 408 MS cases including 320 (78.4%) females and 88 (21.6%) males enrolled in the study. The majority of subjects 299 (73.3%) had relapsing remitting MS. The mean (SD) of EDSS score was 1.88 (1.80) and 1.91 (1.92) before and after Covid-19 infection respectively (p value ≥0.05). Most common symptoms of infection included body aches 246 (60.3%), weakness and lethargy 242 (59.3%), fever 222 (54.4%), loss of sense of taste 206 (50.5%) and dry cough 167 (40.9%) respectively. The most common comorbidity was diabetes among 15 (3.7%) cases. Totally 77 (16.04%) cases were hospitalized and 4 (1%) were died. Conclusions: This study will provide valuable and novel epidemiological knowledge on Iranian MS patients with COVID-19. COVID-19 infection was more common among female and increased EDSS among subjects. The infection symptoms and mortality rate of COVID-19 in MS subjects are comparable to the general population.