COVID-19 infection in NMO/SD patients: a French survey
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LETTER TO THE EDITORS
COVID‑19 infection in NMO/SD patients: a French survey Sinéad Zeidan1 · Elisabeth Maillart1 · Céline Louapre1,2 · Thomas Roux1 · Catherine Lubetzki1,2 · Caroline Papeix1 Received: 30 June 2020 / Revised: 21 July 2020 / Accepted: 23 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Keyword NMOSD · COVID-19 · Immunosuppressants · AQP4 Dear Sirs, COVID-19 pandemic due to SARS-CoV2 virus is ongoing, with a fatality rate around 5.4% [1]. Neuromyelitis optica spectrum disorders (NMO/SD) is a rare disabling disease requiring immunosuppressive therapy. The risk of severe COVID-19 remains unknown in NMO/SD. The aim of this case-series study is to describe the prevalence and characteristics of COVID-19 in NMO/SD patients. We conducted a monocentric retrospective caseseries study of NMO/SD patients with highly suspected or proven COVID-19. They fulfilled at least one of the three NMO diagnostic criteria sets [2–4] and were registered in the NOMADMUS cohort (gathering data from French expert NMO/SD centers). Among 117 NMO/ SD patients followed in the department of neurology of Pitié Salpêtrière Hospital in Paris, 75 were questioned by phone about COVID-19 infection between 05/05/2020 and 06/15/2020 (33 were lost to follow-up, 9 were unreachable by phone). We collected demographics, neurological history, comorbidities, COVID-19 characteristics and outcome. COVID-19 diagnosis was retained on ≥ 1 of the following criteria was fulfilled: (1) positive SARS-CoV2 PCR (naso-pharyngeal swab) or serology (IgG); (2) typical thoracic ground glass opacities on CT scan; (3) acute anosmia/ageusia of sudden onset in the absence of rhinitis or nasal obstruction; (4) typical triad symptoms (cough, fever, asthenia) in epidemic zone of COVID-19. The study received approval from the ethic committee of Sorbonne University (#CER-2020-19). * Caroline Papeix [email protected] 1
Department of Neurology, Pitié Salpêtrière Hospital, APHP, Sorbonne University, 75013 Paris, France
Institut du Cerveau et de la Moelle épinière, ICM, CIC Neuroscience, Paris, France
2
Demographical and clinical characteristics of the 75 NMO/SD questioned by phone are summarized in Table 1. During the lockdown in France (03/17/2020–05/11/2020), neurologists were available at hospital and by phone/video consults. NMO/SD treatments were maintained, including in-hospital infusions. Patients mostly stopped 100% (n = 44; 58.7%) or > 50% of their outings (n = 29; 38.7%); two patients (2.7%) continued to attend their workplace. Nine patients (12.0%) reported an interaction with a symptomatic person. Five patients (6.7% of the whole cohort) fulfilled the diagnosis of COVID-19 (Table 2). Their last biological analysis before COVID-19 [median (Q1–Q3) delay: 45 (10–60) days] found: grade 1 lymphopenia (n = 3/5) or normal lymphocyte count (n = 1/5), and normal neutrophilic counts (n = 4/5, missing data for one patient). The two patients receiving anti-CD20 treatment had a B-lymphocyte depletion. No patient had a severe infectio
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