Disease-modifying therapies, outcomes, risk factors and severity of COVID-19 in multiple sclerosis: A MENACTRIMS registry based study.
Journal: Multiple sclerosis and related disorders
Volume: 90
Issue:
Year of Publication:
Affiliated Institutions:
Inserm U, IRD U, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France; School of Pharmacy, Lebanese American University, Byblos, Lebanon.
Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; National Institute of Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, Lebanon.
Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; National Institute of Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, Lebanon; School of Medicine, Lebanese American University, Byblos, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, , Nicosia, Cyprus.
Harley Street Medical Centre, Neurology Institute, Abu Dhabi, United Arab Emirates.
American University of Beirut Medical Center, Nehme and Therese Tohme Multiple Sclerosis Center, Beirut, Lebanon.
Amiri Hospital, Kuwait, Kuwait.
Ibn Sina Hospital, Kuwait, Kuwait.
Baghdad Medical City Teaching Hospital, Baghdad, Iraq.
Neurology Department, Cairo University, Kasr Alainy School of Medicine, Cairo, Egypt.
MS Department, Rashid Hospital and Dubai Medical College, Dubai Health Authority, Dubai, United Arab Emirates.
Multiple Sclerosis Research Center of Tehran University of Medical Sciences, Tehran, Iran.
Department of Neurology, LRSP, Clinical Investigation Center "Neurosciences and Mental Health"- Razi University Hospital- Mannouba, Tunis, Tunisia.
Department of Neurology, The Royal Hospital, Muscat, Oman.
Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Neurology Department, University Hospital Center, Oran, Algeria.
Inserm U, IRD U, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France.
Harley Street Medical Centre, Neurology Institute, Abu Dhabi, United Arab Emirates. Electronic address: yamoutba@gmail.com.
Abstract summary
There is a lack information regarding risk factors associated with worse COVID-19 outcomes in patients with multiple sclerosis (MS) in the MENA region.This is a multicenter, retrospective cohort study that included all MS patients with a suspected or confirmed COVID-19 infection using the MENACTRIMS registry. The association of demographics, disease characteristics, and use of disease-modifying therapies (DMTs) with outcomes and severity of COVID-19 were evaluated by multivariate logistic model.A total of 600 MS patients with confirmed (n = 542) or highly suspected (n = 58) COVID-19 were analyzed. Seventy-three patients (12.2 %) had a COVID-19 severity score of ≥3 on a 7-point ordinal scale (ranging from 1 [not hospitalized with no limitations on activities] to 7 [death] with a cutoff at 3 [hospitalized and not requiring supplemental oxygen]), and 15 patients (2.5 %) died. Out of 73 patients with a severity score ≥3, 90.4 % were on DMTs; 50.6 % of them were on anti-CD20, including ocrelizumab and rituximab. Multivariate logistic regression showed that older age (odds ratio per 10 years, 1.4 [95 %CI, 1.0-1.8]), disability (OR for EDSS 3.0-5.5, 2.9 [95 %CI. 1.5-5.7], OR for EDSS ≥6.0, 2.3 [95 %CI. 1.0-5.1]), obesity (OR, 3.0 [95 %CI, 1.5-6.0]), and treatment with rituximab (OR, 9.0 [95 %CI, 3.1-25.3]) or off-label immunosuppressive medications (OR, 5.6 [95 %CI. 1.1-27.8]) were risk factors for moderate or severe COVID-19.In this registry-based study of MS patients, age, sex, EDSS, obesity, progressive MS were risk factors for severe COVID-19. Moreover, there was an association found between exposure to anti-CD20 DMTs and COVID-19 severity.
Authors & Co-authors:
Zeineddine Maya M
Al-Hajje Amal A
Salameh Pascale P
Massouh Joelle J
Saab Georges G
Al-Roughani Raed R
Ahmed Samar Farouk SF
Al-Mahdawi Akram A
Shalaby Nevin N
Inshasi Jihad J
Sahraian Mohamad Ali MA
Gouider Riadh R
Mrabet Saloua S
Al-Khabouri Jaber J
Shayganneja Vahid V
Chentouf Amina A
Boumediene Farid F
Yamout Bassem B
Study Outcome
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