RT Journal Article
SR Electronic
T1 Updated Results of the COVID-19 in MS Global Data Sharing Initiative
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e200021
DO 10.1212/NXI.0000000000200021
VO 9
IS 6
A1 Steve Simpson-Yap
A1 Ashkan Pirmani
A1 Tomas Kalincik
A1 Edward De Brouwer
A1 Lotte Geys
A1 Tina Parciak
A1 Anne Helme
A1 Nick Rijke
A1 Jan A. Hillert
A1 Yves Moreau
A1 Gilles Edan
A1 Sifat Sharmin
A1 Tim Spelman
A1 Robert McBurney
A1 Hollie Schmidt
A1 Arnfin B. Bergmann
A1 Stefan Braune
A1 Alexander Stahmann
A1 Rod M. Middleton
A1 Amber Salter
A1 Bruce Bebo
A1 Anneke Van der Walt
A1 Helmut Butzkueven
A1 Serkan Ozakbas
A1 Cavit Boz
A1 Rana Karabudak
A1 Raed Alroughani
A1 Juan I. Rojas
A1 Ingrid A. van der Mei
A1 Guilherme Sciascia do Olival
A1 Melinda Magyari
A1 Ricardo N. Alonso
A1 Richard S. Nicholas
A1 Anibal S. Chertcoff
A1 Ana Zabalza de Torres
A1 Georgina Arrambide
A1 Nupur Nag
A1 Annabel Descamps
A1 Lars Costers
A1 Ruth Dobson
A1 Aleisha Miller
A1 Paulo Rodrigues
A1 Vesna Prčkovska
A1 Giancarlo Comi
A1 Liesbet M. Peeters
YR 2022
UL http://nn.neurology.org/content/9/6/e200021.abstract
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