To describe the demographic, clinical characteristics, and outcomes of people with multiple sclerosis (PwMS) with confirmed COVID-19 at the St. Michael’s Hospital (SMH) MS Clinic in Toronto, Canada.

There have been significant concerns regarding increased COVID-19 related morbidity and mortality among PwMS given that older age, higher disability, vascular comorbidities, and anti-CD20 therapy have been identified as risk factors associated with severe outcomes.  However, emerging evidence suggests that MS and most disease-modifying therapies (DMTs) do not appear to increase the acquisition risk for COVID-19 or secondary morbidity or mortality.  Due to the substantial regional variability of COVID-19 prevalence, there is a sustained need to report and evaluate COVID-19 among PwMS in different locations.

The SMH Clinic Registry was used to identify PwMS with polymerase chain reaction-confirmed COVID-19 between March-October, 2020.  Clinical features and outcomes were obtained using registry data and retrospective chart review.

Among 5600 PwMS, eight patients with relapsing-remitting MS and one person with clinically isolated syndrome developed confirmed COVID-19. The mean age was 43.2 years, 88% were women, and the median EDSS score was 1.0 (range 0–5.5). All but one patient were on DMTs: interferon beta, glatiramer acetate, teriflunomide, dimethyl fumarate, and natalizumab. Two patients received corticosteroids within one month of infection. Three patients had vascular comorbidities. One patient was hospitalized and required non-invasive ventilation without admission to the intensive care unit. One patient was asymptomatic, while seven patients had mild respiratory and/or systemic symptoms. All subjects continued their DMTs and recovered without MS relapse.

Our findings suggest that the number of PwMS followed in our clinic in Toronto, Canada, with confirmed COVID-19 was low, without strong representation by a particular DMT. Our findings highlight the regional variability of COVID-19 prevalence and the importance of contextualizing risk at a regional level to optimize the management of PwMS.