Enhancing Clinical Outcomes and Survival in Hospitalized Multiple Sclerosis Patients With Covid-19: Challenges of Antiviral Therapy Publisher



Z Maghbooli ZHILA ; A Kasaeian AMIR ; Mr Fattahi Mohammad REZA ; T Varzandi TARLAN ; S Hamtaeigashi SARA ; S Mohammadnabi SARA ; Ma Sahraian Mohammad ALI
Source: Physiology and Pharmacology (Iran) Published:2025

Abstract

Introduction:This study aimed to evaluate the efficacy and safety concerns of remdesivir and type 1 interferons on the clinical outcomes of hospitalized multiple sclerosis patients with COVID-19. Methods: Using electronic health records systems; this is a cross-sectional study of two years of hospital admissions in terms of COVID-19 in Iran from March 2019 to August 2021. The severities of COVID-19 outcomes were ICU admission, hospitalization days, and 30-day survival rates. Results: A total of 993 hospitalized multiple sclerosis patients with a confirmed diagnosis of COVID-19 based on PCR testing were recorded in the electronic health systems. Nearly half of these patients (50.3%) had received treatment with an anti-CD20 agent (rituximab or ocrelizumab) at the hospital admission. This group exhibited higher mortality rates, increased need for ICU admission, and longer hospitalization (p<0.05). There was a significant association between taking interferon-β1 alone (adjusted IRR=1.21, 95% CI 1.32 to 1.42) or in combination with remdesivir (adjusted IRR=1.30, 95% CI 1.18 to 1.5042) and longer hospitalization. There were no significant associations between antiviral treatment (remdesivir alone, interferon-β1-β1 alone, and interferon-β1plus remdesivir) and ICU admission (p>0.2), the in-hospital mortality rate (p>0.2), or 30-day survival rate (p>0.2). The results were similar in patients who did or did not receive anti-CD20 agents. These results were consistent among patients regardless of whether they received anti-CD20 agents. Conclusion: Our data suggest that remdesivir, interferon-β1, or a combination of both does not benefit hospitalized MS patients with COVID-19. © 2025 Elsevier B.V., All rights reserved.