Multiple sclerosis and COVID‐19: How many are at risk?

BACKGROUND AND PURPOSE: The coronavirus disease 2019 (COVID‐19) pandemic challenges neurologists in counseling multiple sclerosis (MS) patients with respect to their risk for and by severe acute respiratory syndrome coronavirus 2 and in guiding disease‐modifying treatment (DMT). The objective was to determine the frequency and distribution of currently known risk factors for COVID‐19 mortality in an MS population. METHODS: Multiple sclerosis patients with at least one complete case report between January 1, 2015 and December 31, 2019 from the Innsbruck MS database were cross‐sectionally included. Frequencies of currently estimated COVID‐19 mortality risk factors were analyzed, and the cumulative risk was calculated by a recently developed score. For every risk group, the proportions of patients under DMT and immunosuppressive treatment were determined. RESULTS: Of 1931 MS patients, 63.4% had low risk of COVID‐19 mortality, 26% had mild risk, 8.8% had a moderate risk, whereas a combined 0.9% had high or very high risk of COVID‐19 mortality. Of the patients at high or very high risk, only one patient received DMT and none had an immunosuppressive therapy. CONCLUSIONS: In a population‐based MS cohort, the proportion of patients at high risk of COVID‐19 mortality is below 1%. Importantly, the vast majority of these MS patients did not receive any DMT.