Assessment of differences in clinical consequences between rituximab and interferon recipients in multiple sclerosis patients after recovery from COVID-19.

Background: Multiple sclerosis (MS) patients using disease-modifying treatments (DMTs) are at serious danger from the Coronavirus Disease 2019 (COVID-19) pandemic, which is brought on by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This could make infections more severe. This study postulated that because of the immunosuppressive effects of Rituximab, MS patients treated with this medication would have worse clinical outcomes after recovering from COVID-19 than those treated with Interferon. Method: This cross-sectional study at Imam Khomeini Hospital, Urmia, Iran, included 34 MS patients with confirmed COVID-19 (2019-2022), treated with Interferon (n = 12) or Rituximab (n = 22). Demographic data, MS phenotype, Expanded Disability Status Scale (EDSS), COVID-19 severity, hospitalization duration, mortality, and reinfection rates were analyzed using SPSS version 27. Statistical comparisons used independent t-tests and Chi-square/Fisher's exact tests (p < 0.05). Result: Patients had a mean age of 44.74 ± 8.85 years (range: 18-60). Rituximab-treated patients had significantly longer hospitalizations (6-10 days: 10 vs. 5 patients, 11-20 days: 5 vs. 0, p = 0.032, 95 % CI: 1.2-3.5), higher mortality (3 vs. 0, p = 0.041, odds ratio: 2.8, 95 % CI: 1.1-7.2), greater MS severity (EDSS≥2: 18 vs. 2, p = 0.028, 95 % CI: 1.3-4.1), and higher reinfection rates (8 vs. 0, p = 0.037, 95 % CI: 1.2-5.0) compared to Interferon-treated patients. Conclusion: Compared to interferon, rituximab was linked to worse clinical outcomes in MS patients after COVID-19 recovery, indicating that its use during pandemics should be used with caution.