COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context
- Creators
- Sormani M. P.
- Schiavetti I.
- Carmisciano L.
- Cordioli C.
- Filippi M.
- Radaelli M.
- Immovilli P.
- Capobianco M.
- De Rossi N.
- Brichetto G.
- Cocco E.
- Scandellari C.
- Cavalla P.
- Pesci I.
- Zito A.
- Confalonieri P.
- Marfia G. A.
- Perini P.
- Inglese M.
- Trojano M.
- Brescia Morra V.
- Tedeschi G.
- Comi G.
- Battaglia M. A.
- Patti F.
- Salvetti M.
- Others:
- Sormani, M. P.
- Schiavetti, I.
- Carmisciano, L.
- Cordioli, C.
- Filippi, M.
- Radaelli, M.
- Immovilli, P.
- Capobianco, M.
- De Rossi, N.
- Brichetto, G.
- Cocco, E.
- Scandellari, C.
- Cavalla, P.
- Pesci, I.
- Zito, A.
- Confalonieri, P.
- Marfia, G. A.
- Perini, P.
- Inglese, M.
- Trojano, M.
- Brescia Morra, V.
- Tedeschi, G.
- Comi, G.
- Battaglia, M. A.
- Patti, F.
- Salvetti, M.
Description
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.
Additional details
- URL
- http://hdl.handle.net/11567/1068226
- URN
- urn:oai:iris.unige.it:11567/1068226
- Origin repository
- UNIGE