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Covid-19 Among Patients With Multiple Sclerosis a Systematic Review Publisher Pubmed



Barzegar M1 ; Mirmosayyeb O1 ; Gajarzadeh M2 ; Afsharisafavi A4 ; Nehzat N1 ; Vaheb S1 ; Shaygannejad V1 ; Maghzi AH6
Authors
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Authors Affiliations
  1. 1. Department of Neurology
  2. 2. Universal Scientific Education and Research Network (USERN), School of Medicine, Isfahan University of Medical Sciences
  3. 3. Universal Council of Epidemiology (UCE)
  4. 4. Tehran University of Medical Sciences
  5. 5. Department of Biostatistics and Epidemiology (A.A.-S.), Faculty of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
  6. 6. Ann Romney Center for Neurologic Diseases, Harvard Medical School, Brigham and Women's Hospital, Boston, United States

Source: Neurology: Neuroimmunology and NeuroInflammation Published:2021


Abstract

Objective We systematically reviewed the literature on COVID-19 in patients with multiple sclerosis (MS). Methods We searched PubMed, Scopus, EMBASE, CINAHL, Web of Science, Google Scholar, and World Health Organization database from December 1, 2019, to December 18, 2020. Three conference abstract databases were also searched. We included any types of studies that reported characteristics of patients with MS with COVID-19. Results From an initial 2,679 publications and 3,138 conference abstracts, 87 studies (67 published articles and 20 abstracts) consisting of 4,310 patients with suspected/confirmed COVID-19 with MS met the inclusion criteria. The female/male ratio was 2.53:1, the mean (SD) age was 44.91 (4.31) years, the mean disease duration was 12.46 (2.27), the mean Expanded Disability Status Scale score was 2.54 (0.81), the relapsing/progressive ratio was 4.75:1, and 32.9% of patients had at least 1 comorbidity. The most common symptoms were fever (68.8%), followed by cough (63.9%), fatigue/asthenia (51.2%), and shortness of breath (39.5%). In total, 837 of 4,043 patients with MS with suspected/confirmed COVID-19 (20.7%) required hospitalization, and 130 of 4,310 (3.0%) died of COVID-19. Among suspected/confirmed patients, the highest hospitalization and mortality rates were in patients with no disease-modifying therapies (42.9% and 8.4%), followed by B cell-depleting agents (29.2% and 2.5%). Conclusion Our study suggested that MS did not significantly increase the mortality rate from COVID-19. These data should be interpreted with caution as patients with MS are more likely female and younger compared with the general population where age and male sex seem to be risk factors for worse disease outcome. Copyright © 2021 The Author(s).
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