Background and ObjectivesIt 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.MethodsHospitalization, 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 chi (2) test, and the risk excess was quantified by risk ratios (RRs).ResultsThe 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).DiscussionOverall, 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.

COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context / Sormani, Maria Pia; Schiavetti, Irene; Carmisciano, Luca; Cordioli, Cinzia; Filippi, Massimo; Radaelli, Marta; Immovilli, Paolo; Capobianco, Marco; De Rossi, Nicola; Brichetto, Giampaolo; Cocco, Eleonora; Scandellari, Cinzia; Cavalla, Paola; Pesci, Ilaria; Zito, Antonio; Confalonieri, Paolo; Marfia, Girolama Alessandra; Perini, Paola; Inglese, Matilde; Trojano, Maria; Brescia Morra, Vincenzo; Tedeschi, Gioacchino; Comi, Giancarlo; Battaglia, Mario Alberto; Patti, Francesco; Salvetti, Marco; Zarbo, Ignazio Roberto; Sotgiu, Stefano. - In: NEUROLOGY® NEUROIMMUNOLOGY & NEUROINFLAMMATION. - ISSN 2332-7812. - 9:1(2022), p. 1105. [10.1212/NXI.0000000000001105]

COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Zarbo, Ignazio Roberto;Sotgiu, Stefano
2022-01-01

Abstract

Background and ObjectivesIt 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.MethodsHospitalization, 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 chi (2) test, and the risk excess was quantified by risk ratios (RRs).ResultsThe 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).DiscussionOverall, 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.
2022
COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context / Sormani, Maria Pia; Schiavetti, Irene; Carmisciano, Luca; Cordioli, Cinzia; Filippi, Massimo; Radaelli, Marta; Immovilli, Paolo; Capobianco, Marco; De Rossi, Nicola; Brichetto, Giampaolo; Cocco, Eleonora; Scandellari, Cinzia; Cavalla, Paola; Pesci, Ilaria; Zito, Antonio; Confalonieri, Paolo; Marfia, Girolama Alessandra; Perini, Paola; Inglese, Matilde; Trojano, Maria; Brescia Morra, Vincenzo; Tedeschi, Gioacchino; Comi, Giancarlo; Battaglia, Mario Alberto; Patti, Francesco; Salvetti, Marco; Zarbo, Ignazio Roberto; Sotgiu, Stefano. - In: NEUROLOGY® NEUROIMMUNOLOGY & NEUROINFLAMMATION. - ISSN 2332-7812. - 9:1(2022), p. 1105. [10.1212/NXI.0000000000001105]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11388/305154
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