COVID-19 Hits Black MS Patients Hard

Stuart Schlossman#COVID-19, Multiple Sclerosis

— COViMS registry gives first look at outcomes among North American patients

by Judy George, Senior Staff Writer, MedPage Today 

Black patients with multiple sclerosis (MS) and SARS-CoV-2 virus had a different COVID-19 disease course and worse outcomes than white MS patients with the virus, data from the clinician-based COViMS registry showed.

Black race was associated with increased odds of a composite outcome of mortality or ICU admission (OR 3.7), and increased odds of a composite outcome of mortality, ICU admission, or hospitalization (OR 1.7), reported Amber Salter, PhD, of Washington University School of Medicine in St. Louis, at MS Virtual 2020, the joint ACTRIMS-ECTRIMS meeting.

“Race and ethnicity are critical components to understanding MS disparities and the impact of the SARS-CoV-2 virus,” Salter told MedPage Today.

“Our study finds that much like the general population, Black patients with MS have an increased odds of more severe COVID-19 disease course compared to white patients with MS, after controlling for other risk factors such as age, sex, comorbidities, disease-modifying therapy use, and disability.”

The study was based on data from the COViMS registry, a joint effort of the Consortium of MS Centers, the MS Society of Canada, and the National MS Society. The registry contained de-identified patient data submitted by clinicians who treated MS patients with confirmed or suspected COVID-19 from April 1 to August 31. Nearly all patients in the study (98%) were from the U.S.

Analyses included only white and Black MS patients. Of 858 MS patients in the COViMS study, 503 (58.6%) were reported as non-Hispanic white and 223 (26.0%) as Black.

Black patients were age 47.1 on average and had mean disease duration of 11.4 years. Most Black MS patients (77%) were female, 73% were fully ambulatory, and 71% were never-smokers. Eight in 10 Black patients (82%) had relapsing-remitting disease, 13% had secondary progressive, and 4% had primary progressive MS.

White patients were age 50.8 on average and had mean disease duration of 15.2 years, while 72% were female, 69% were fully ambulatory, and 59% were never-smokers. More than seven in 10 (73%) white patients had relapsing-remitting MS; 19% had secondary progressive, and 7% had primary progressive disease.

About 42% of Black MS patients had hypertension, compared with 19.5% of white patients (P<0.001). In addition, 16% of Black MS patients had morbid obesity, compared with 9% of white patients (P=0.004).

“A higher percentage of black MS patients had hypertension, cerebrovascular disease, chronic lung disease, and diabetes, which are known risk factors for worse outcomes from COVID-19 infection,” said Benjamin Segal, MD, of The Ohio State University in Columbus, who was not involved with the study.

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