PT - JOURNAL ARTICLE AU - Maria Pia Sormani AU - Irene Schiavetti AU - Luca Carmisciano AU - Cinzia Cordioli AU - Massimo Filippi AU - Marta Radaelli AU - Paolo Immovilli AU - Marco Capobianco AU - Nicola De Rossi AU - Giampaolo Brichetto AU - Eleonora Cocco AU - Cinzia Scandellari AU - Paola Cavalla AU - Ilaria Pesci AU - Antonio Zito AU - Paolo Confalonieri AU - Girolama Alessandra Marfia AU - Paola Perini AU - Matilde Inglese AU - Maria Trojano AU - Vincenzo Brescia Morra AU - Gioacchino Tedeschi AU - Giancarlo Comi AU - Mario Alberto Battaglia AU - Francesco Patti AU - Marco Salvetti AU - on behalf of the MuSC-19 Study Group TI - COVID-19 Severity in Multiple Sclerosis AID - 10.1212/NXI.0000000000001105 DP - 2022 Jan 01 TA - Neurology - Neuroimmunology Neuroinflammation PG - e1105 VI - 9 IP - 1 4099 - http://nn.neurology.org/content/9/1/e1105.short 4100 - http://nn.neurology.org/content/9/1/e1105.full SO - Neurol Neuroimmunol Neuroinflamm2022 Jan 01; 9 AB - Background and Objectives It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19–related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population.Methods Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1,362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score > 3 or at least 1 comorbidity, lower risk: EDSS score ≤ 3 and no comorbidities) by the χ2 test, and the risk excess was quantified by risk ratios (RRs).Results The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization (p < 0.001), RR = 2.19 for ICU admission (p < 0.001), and RR = 2.43 for death (p < 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04).Discussion Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon.DMT=disease-modifying therapy; EDSS=Expanded Disability Status Scale; ICU=intensive care unit; ISS=Istituto Superiore di Sanità; MS=multiple sclerosis; RR=risk ratio; RT-PCR=reverse transcriptase-polymerase chain reaction; SARS-CoV-2=severe acute respiratory syndrome coronavirus 2