Abstract Details

Title COVID-19 Outcomes in Neurosarcoidosis

Topic Autoimmune Neurology

Presentation(s) P9 - Poster Session 9 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-012

Objective To investigate outcomes of coronavirus disease 2019 (COVID-19) in neurosarcoidosis (NS).

Background A prior study investigating COVID-19 outcomes in systemic sarcoidosis has identified patients with neurologic involvement to be at increased risk for COVID-19 complications. Questions remain regarding what features of neurosarcoidosis predispose to a more severe COVID-19 course.

Design/Methods Patients diagnosed with neurosarcoidosis were included if the electronic medical record indicated the patient had been infected with COVID-19.

Results Twenty-one patients with NS were included with a median age of 57 years (range 22-75) and median illness duration of 96 months (range 2-348) at the time of the COVID-19 infection. Eight (38.1%) had active-uncontrolled NS disease, five (23.8%) had active-controlled disease, and eight (38.1%) had inactive disease. 15/21 (71.4%) were on immunosuppressants, most commonly steroids (12, 57.1%), infliximab (9, 42.9%), and methotrexate (8, 38.1%). 10/21 (47.6%) had documented vaccination records against COVID-19 prior to the infection, while the remaining were un- or inadequately vaccinated. No adverse reactions to vaccinations were reported. Only one patient was asymptomatic of COVID-19. 7/20 (35.0%) patients (all immunosuppressed and 5 vaccinated) required hospital admission for a median of 7 days, including one unvaccinated patient (1/19, 5.3%) in a ventilated ICU setting. 8 patients (8/21, 38.1%) received anti-COVID treatments (remdesivir, monoclonal antibodies, or nirmatrelvir/ritonavir), all but one of which were immunosuppressed and five of which were vaccinated. Adjustments to immunosuppressants were made in 4 patients (4/21, 19.0%) during the active infection. 18/21 (85.7%) recovered completely from infection. One (1/21, 4.7%) patient died from COVID-19. 2/17 patients (11%) with follow-up data experienced clinical symptoms suggestive of NS relapse or progression within 90 days of infection.

Conclusions Most NS patients experienced symptomatic COVID-19 infection, including a higher rate of hospitalization than previously reported in the general population. Most patients experiencing severe disease were immunosuppressed and vaccinated.

Authors/Disclosures
Sally El Sammak, MD (Emory University) PRESENTER	Dr. El Sammak has nothing to disclose.
Gabriela A. Bou, MD (Emory University School of Medicine)	Dr. Bou has nothing to disclose.
Spencer Hutto, MD (Emory University: Neurology Residency Program)	Dr. Hutto has nothing to disclose.

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