Better COVID-19 Outcomes in MOGAD Than NMOSD, Registry Data Show

Scott Newsome, DO, MSCS, FAAN

Recently reported data show that patients with neuromyelitis optica spectrum disorder (NMOSD) have a high COVID-19 mortality rate and that those with other comorbidities have worse outcomes if they contract the virus. Additionally, data suggest patients with myelin oligodentrocyte glycoprotein antibody disease (MOGAD) have better outcomes than those with NMOSD, as there were fewer reported severe COVID-19 outcomes and no deaths reported. 

Data was reported from the COVID-19 Infections in MS and Related Diseases (COViMS) Registry, which collected information from patients with multiple sclerosis (MS) and other related diseases in North America. Patients included in the registry either had a laboratory confirmed diagnosis of SARS-CoV-2 infection, or highly suspected infection.

A total of 66 patients with NMOSD and 15 patients with MOGAD were logged in the registry as of April 1, 2021. Most patients with NMOSD had a laboratory positive COVID-19 diagnosis and were taking rituximab (Rituxan; Genentech/Biogen) when diagnosed.

Investigators, led by Scott Newsome, DO, MSCS, FAAN, president, CMSC, director, Neurosciences Consultation and Infusion Center at Green Spring Station, and associate professor of neurology, Johns Hopkins Medicine, found that a majority of included patients with NMOSD, 66.7%, were not hospitalized (95% CI, 54.0-77.8), while 12.1% of patients were hospitalized only (95% CI, 5.4-22.5). In addition, 9.1% of patients were admitted to the intensive care unit (ICU) and/or were ventilated (95% CI, 3.4-18.7) and 12.1% (95% CI, 5.4-22.5) died. 

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Poorer COVID-19 outcome in patients with NMOSD was associated solely with having a comorbidity (OR, 6.3; 95% CI, 1.64-24.52). Comparably, there were no identified factors among patients with MOGAD indicating a difference between those who were hospitalized vs not hospitalized, admitted to the ICU, or put on a ventilator.

There were no deaths reported amongst patients with MOGAD, and a total of 73.3% were not hospitalized as a result of COVID-19 infection. Similar to those with NMOSD, most patients with MOGAD received a laboratory positive diagnosis of SARS-CoV-2 and over half were taking rituximab when diagnosed. 

Findings were presented at the 2021 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC), October 25-28. Data was entered into the COViMS registry by healthcare providers online, which was then analyzed by investigators using t tests, and categorical variable were evaluated using Fisher exact tests or Pearson’s Chi-Square Test.

Investigators intended to identify the impact of the virus on patients with both NMOSD and MOGAD, as little data had been available thus far.

“The COVID-19 pandemic caused by SARS-CoV-2 raised concerns about the risk of COVID-19 in those with neuroimmunologic disorders that affect the central nervous system,” Newsome et al wrote. “Risk factors associated with worse COVID-19 outcomes in MS include increased hospitalizations with B-cell–depleting therapies, recent treatment with glucocortoid use, and Black or African America race. However, little data have been reported on how COVID-19 impacts people with NMOSDs and MOGAD.” 

For more coverage of CMSC 2021, click here.

REFERENCE

Newsome SD, Cross AH, Fox RJ, et al. COVID-19 in neuromyelitis optica spectrum disorders and myelin oligodendrocyte glycoprotein antibody disease patients in North America. Presented at 2021 CMSC Annual Meeting; October 25-28. Abstract DXM08.