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Abstract Details

COVID-19 Outcomes in Neurosarcoidosis
Autoimmune Neurology
P9 - Poster Session 9 (5:30 PM-6:30 PM)
A prior study investigating COVID-19 outcomes in systemic sarcoidosis has identified patients with neurologic involvement to be at increased risk for COVID-19 complications. Questions remain regarding what features of neurosarcoidosis predispose to a more severe COVID-19 course.
To investigate outcomes of coronavirus disease 2019 (COVID-19) in neurosarcoidosis (NS).
Patients diagnosed with neurosarcoidosis were included if the electronic medical record indicated the patient had been infected with COVID-19.
Twenty-one patients with NS were included with a median age of 57 years (range 22-75) and median illness duration of 96 months (range 2-348) at the time of the COVID-19 infection. Eight (38.1%) had active-uncontrolled NS disease, five (23.8%) had active-controlled disease, and eight (38.1%) had inactive disease. 15/21 (71.4%) were on immunosuppressants, most commonly steroids (12, 57.1%), infliximab (9, 42.9%), and methotrexate (8, 38.1%). 10/21 (47.6%) had documented vaccination records against COVID-19 prior to the infection, while the remaining were un- or inadequately vaccinated. No adverse reactions to vaccinations were reported. Only one patient was asymptomatic of COVID-19. 7/20 (35.0%) patients (all immunosuppressed and 5 vaccinated) required hospital admission for a median of 7 days, including one unvaccinated patient (1/19, 5.3%) in a ventilated ICU setting. 8 patients (8/21, 38.1%) received anti-COVID treatments (remdesivir, monoclonal antibodies, or nirmatrelvir/ritonavir), all but one of which were immunosuppressed and five of which were vaccinated. Adjustments to immunosuppressants were made in 4 patients (4/21, 19.0%) during the active infection. 18/21 (85.7%) recovered completely from infection. One (1/21, 4.7%) patient died from COVID-19. 2/17 patients (11%) with follow-up data experienced clinical symptoms suggestive of NS relapse or progression within 90 days of infection.
Most NS patients experienced symptomatic COVID-19 infection, including a higher rate of hospitalization than previously reported in the general population. Most patients experiencing severe disease were immunosuppressed and vaccinated.
Sally El Sammak, MD (Emory University)
Dr. El Sammak has nothing to disclose.
Gabriela Alejandra Bou, MD (Emory University Department of Neurology) Dr. Bou has nothing to disclose.
Spencer Hutto, MD (Emory University: Neurology Residency Program) Dr. Hutto has nothing to disclose.