PT  - JOURNAL ARTICLE
AU  - Steve Simpson-Yap
AU  - Ashkan Pirmani
AU  - Tomas Kalincik
AU  - Edward De Brouwer
AU  - Lotte Geys
AU  - Tina Parciak
AU  - Anne Helme
AU  - Nick Rijke
AU  - Jan A. Hillert
AU  - Yves Moreau
AU  - Gilles Edan
AU  - Sifat Sharmin
AU  - Tim Spelman
AU  - Robert McBurney
AU  - Hollie Schmidt
AU  - Arnfin B. Bergmann
AU  - Stefan Braune
AU  - Alexander Stahmann
AU  - Rod M. Middleton
AU  - Amber Salter
AU  - Bruce Bebo
AU  - Anneke Van der Walt
AU  - Helmut Butzkueven
AU  - Serkan Ozakbas
AU  - Cavit Boz
AU  - Rana Karabudak
AU  - Raed Alroughani
AU  - Juan I. Rojas
AU  - Ingrid A. van der Mei
AU  - Guilherme Sciascia do Olival
AU  - Melinda Magyari
AU  - Ricardo N. Alonso
AU  - Richard S. Nicholas
AU  - Anibal S. Chertcoff
AU  - Ana Zabalza de Torres
AU  - Georgina Arrambide
AU  - Nupur Nag
AU  - Annabel Descamps
AU  - Lars Costers
AU  - Ruth Dobson
AU  - Aleisha Miller
AU  - Paulo Rodrigues
AU  - Vesna Prčkovska
AU  - Giancarlo Comi
AU  - Liesbet M. Peeters
TI  - Updated Results of the COVID-19 in MS Global Data Sharing Initiative
AID  - 10.1212/NXI.0000000000200021
DP  - 2022 Nov 01
TA  - Neurology - Neuroimmunology Neuroinflammation
PG  - e200021
VI  - 9
IP  - 6
4099  - http://nn.neurology.org/content/9/6/e200021.short
4100  - http://nn.neurology.org/content/9/6/e200021.full
SO  - Neurol Neuroimmunol Neuroinflamm2022 Nov 01; 9
AB  - Background and Objectives Certain demographic and clinical characteristics, including the use of some disease-modifying therapies (DMTs), are associated with severe acute respiratory syndrome coronavirus 2 infection severity in people with multiple sclerosis (MS). Comprehensive exploration of these relationships in large international samples is needed.Methods Clinician-reported demographic/clinical data from 27 countries were aggregated into a data set of 5,648 patients with suspected/confirmed coronavirus disease 2019 (COVID-19). COVID-19 severity outcomes (hospitalization, admission to intensive care unit [ICU], requiring artificial ventilation, and death) were assessed using multilevel mixed-effects ordered probit and logistic regression, adjusted for age, sex, disability, and MS phenotype. DMTs were individually compared with glatiramer acetate, and anti-CD20 DMTs with pooled other DMTs and with natalizumab.Results Of 5,648 patients, 922 (16.6%) with suspected and 4,646 (83.4%) with confirmed COVID-19 were included. Male sex, older age, progressive MS, and higher disability were associated with more severe COVID-19. Compared with glatiramer acetate, ocrelizumab and rituximab were associated with higher probabilities of hospitalization (4% [95% CI 1–7] and 7% [95% CI 4–11]), ICU/artificial ventilation (2% [95% CI 0–4] and 4% [95% CI 2–6]), and death (1% [95% CI 0–2] and 2% [95% CI 1–4]) (predicted marginal effects). Untreated patients had 5% (95% CI 2–8), 3% (95% CI 1–5), and 1% (95% CI 0–3) higher probabilities of the 3 respective levels of COVID-19 severity than glatiramer acetate. Compared with pooled other DMTs and with natalizumab, the associations of ocrelizumab and rituximab with COVID-19 severity were also more pronounced. All associations persisted/enhanced on restriction to confirmed COVID-19.Discussion Analyzing the largest international real-world data set of people with MS with suspected/confirmed COVID-19 confirms that the use of anti-CD20 medication (both ocrelizumab and rituximab), as well as male sex, older age, progressive MS, and higher disability are associated with more severe course of COVID-19.aβ=adjusted β; BMI=body mass index; COVID-19=coronavirus disease 2019; DMT=disease-modifying therapy; EDSS=Expanded Disability Status Scale; ICU=intensive care unit; MS=multiple sclerosis; RRMS=relapsing-remitting MS