Socioeconomic status affects the incidence of COVID-19 in Chilean multiple sclerosis patients

Objective: To investigate the frequency of coronavirus disease (COVID-19) in patients with multiple sclerosis (pwMSs) living in a high socioeconomic vulnerability area in Chile.

Methods: In this prospective cohort study, we compared the frequency of COVID-19 in 52 Chilean pwMSs on disease-modifying treatments (DMTs), living in urban municipalities with low-income/high-poverty levels, with that previously reported in pwMSs living in municipalities with high-income/low-poverty rates in Santiago, Chile. Demographic and clinical features of the pwMSs were obtained from their last consultation between March 3, 2020, and August 29, 2020.

Results: In the low-income pwMSs, the mean patient age was 34 years, 69% were women, mean disease duration was 3 years, and mean Expanded Disability Status Scale score was 1.6. Of these, 61.5% pwMSs (32/52) underwent quarantine during the study period. COVID-19 diagnosis was confirmed by reverse transcriptase polymerase chain reaction in five patients (10%): two were on glatiramer acetate, one was on fingolimod, and two were on alemtuzumab. All pwMSs with COVID-19 recovered fully. The previously reported frequency of confirmed COVID-19 in middle‒upper income pwMSs living in Santiago was 1%. The frequency of COVID-19 among pwMSs in the low- and middle‒high income inhabitants of Santiago differed significantly (z = -4.3235, p < 0.00001; one-tailed Fisher exact test, p < 0.01).

Conclusion: The frequency of COVID-19 in the low-income/high-poverty cohort in Santiago, Chile, was markedly high. Accordingly, high socioeconomic vulnerability should be considered as an important risk factor for COVID-19 in pwMSs.