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Background: Coronavirus Disease 2019 (COVID-19) recently created a pandemic with high
mortality. People with underlying diseases are prone to severe infection. The nature of NMOSD
disease and its treatment by immunosuppressants predisposes patients to infection.
Objectives: This study aimed to evaluate the effect of the COVID-19 pandemic on the clinical
course of NMOSD and the characteristics of COVID-19 infection in NMOSD patients.
Materials & Methods: This descriptive study was performed in Isfahan City, Iran, Iran, from
March 2020 to March 2021. We considered relapses during the epidemic and the year before and the
presentation of COVID-19 infection in the patients of NMOSD Clinic of Isfahan Kashani hospital.
Results: The study included 120 patients. Their Mean±SD age was 36.37±9.69 years, and the
mean duration of disease was 8.49±5.35 years. Overall, they experienced 36 relapses during the
year before the epidemic (ARR:0.3) and 29 during the COVID-19 epidemic (ARR:0.24). The
maintenance therapy of NMOSD was rituximab in 96 cases, azathioprine in 22, and methotrexate in
2 ones. 35 patients infected by COVID-19 (based on RT-PCR test). 6 were admitted to the hospital,
and two patients received ICU care. There was one death due to respiratory failure.
Conclusion: Despite the suppression of the immune system, neither incidence nor the number of
severe complications of COVID-19 infection was high. Therefore, regarding the disabling nature of
NMOSD and the prolonged epidemic period, it may be reasonable to continue the routine treatment
of these patients and train them to stick to health protection instructions.

Keywords: SARS-CoV-2, Pandemics, Neuromyelitis Optica, Demyelinating autoimmune diseases, CNS

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