Abstract Details

Title Immunosuppression in Chronic Autoimmune Neurological Disorders during the COVID-19 Pandemic

Topic Autoimmune Neurology

Presentation(s) P13 - Poster Session 13 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-001

Background NA

Objective To study the risk of acquiring Corona Virus Disease 2019 (COVID-19) and its outcomes in patients on immunosuppressive therapy (IST) for chronic autoimmune neuromuscular disorders (aNMD) and multiple sclerosis (MS).

Design/Methods We used TriNetX, a global health collaborative clinical research platform collecting real-time electronic medical records data, which has one of the largest known global COVID-19 database. We included patients with chronic autoimmune neuromuscular disorders (aNMD) [myasthenia gravis (MG), inflammatory myositis, and chronic inflammatory neuropathies (CIN)] and MS, based on the International Classification of Disease-10 (ICD-10) coding for one year before January 20th, 2020. We examined the use of IST, rate of COVID- 19, hospitalization, intubation, and mortality among the patients with aNMD and MS.

Results A total of 33,451 patients with aNMD and 42,899 patients with MS were included. Among them, 111 (0.33%) patients with aNMD and 115 patients (0.27%) with MS had COVID-19. About one third of them required hospitalization. IST did not appear to have a significant impact on overall infection risk in either group; however, risk of hospitalization for immunosuppressed patients with aNMD was higher (Odds ratio 2.86, p-value 0.011).

Conclusions IST use does not appear to make patients with aNMD and MS more vulnerable to COVID-19. IST may be continued during the pandemic, as previously suggested by expert opinion guidelines. However, it is important to consider individualizing immunotherapy regimens in some cases. Additional physician reported registry-based data is needed to further confirm these findings.

Authors/Disclosures
Shubham Biyani, MBBS PRESENTER	Dr. Biyani has nothing to disclose.
Abhilash Thatikala, MD, MBBS, DM (UAMS)	Dr. Thatikala has nothing to disclose.
Rohan Sharma, MD	Dr. Sharma has nothing to disclose.
Sukanthi Kovvuru, MD (University of Arkansas Medical Sciences)	Dr. Kovvuru has nothing to disclose.
Krishna Nalleballe, MD, FAAN	Dr. Nalleballe has nothing to disclose.
Sanjeeva R. Onteddu, MD, FAAN (UMass Medical School)	Dr. Onteddu has nothing to disclose.
Nidhi Kapoor, MD, MBBS (Baptist Medical Center)	Dr. Kapoor has nothing to disclose.
Karthika D. Veerapaneni, MD	Dr. Veerapaneni has nothing to disclose.
Sisira Yadala, MD, FAAN	Dr. Yadala has nothing to disclose.
Robert L. Archer, MD, FAAN (University of Arkansas for Medical Sciences)	No disclosure on file