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Disease-Modifying Therapies, Outcomes, Risk Factors and Severity of Covid-19 in Multiple Sclerosis: A Menactrims Registry Based Study Publisher Pubmed



Zeineddine M1, 2 ; Alhajje A3, 4 ; Salameh P3, 4, 5, 6 ; Massouh J7 ; Saab G8 ; Alroughani R9 ; Ahmed SF10 ; Almahdawi A11 ; Shalaby N12 ; Inshasi J13 ; Sahraian MA14 ; Gouider R15 ; Mrabet S15 ; Alkhabouri J16 Show All Authors
Authors
  1. Zeineddine M1, 2
  2. Alhajje A3, 4
  3. Salameh P3, 4, 5, 6
  4. Massouh J7
  5. Saab G8
  6. Alroughani R9
  7. Ahmed SF10
  8. Almahdawi A11
  9. Shalaby N12
  10. Inshasi J13
  11. Sahraian MA14
  12. Gouider R15
  13. Mrabet S15
  14. Alkhabouri J16
  15. Shayganneja V17
  16. Chentouf A18
  17. Boumediene F1
  18. Yamout B7
Show Affiliations
Authors Affiliations
  1. 1. Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France
  2. 2. School of Pharmacy, Lebanese American University, Byblos, Lebanon
  3. 3. Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
  4. 4. National Institute of Public Health, Clinical Epidemiology and Toxicology (INSPECT-LB), Beirut, Lebanon
  5. 5. School of Medicine, Lebanese American University, Byblos, Lebanon
  6. 6. Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, 2417, Cyprus
  7. 7. Harley Street Medical Centre, Neurology Institute, Abu Dhabi, United Arab Emirates
  8. 8. American University of Beirut Medical Center, Nehme and Therese Tohme Multiple Sclerosis Center, Beirut, Lebanon
  9. 9. Amiri Hospital, Kuwait, Kuwait
  10. 10. Ibn Sina Hospital, Kuwait, Kuwait
  11. 11. Baghdad Medical City Teaching Hospital, Baghdad, Iraq
  12. 12. Neurology Department, Cairo University, Kasr Alainy School of Medicine, Cairo, Egypt
  13. 13. MS Department, Rashid Hospital and Dubai Medical College, Dubai Health Authority, Dubai, United Arab Emirates
  14. 14. Multiple Sclerosis Research Center of Tehran University of Medical Sciences, Tehran, Iran
  15. 15. Department of Neurology, Clinical Investigation Center “Neurosciences and Mental Health”- Razi University Hospital- Mannouba, LR18SP03, Tunis, Tunisia
  16. 16. Department of Neurology, The Royal Hospital, Muscat, Oman
  17. 17. Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  18. 18. Neurology Department, University Hospital Center, Oran, Algeria

Source: Multiple Sclerosis and Related Disorders Published:2024


Abstract

Background: There is a lack information regarding risk factors associated with worse COVID-19 outcomes in patients with multiple sclerosis (MS) in the MENA region. Methods: 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. Results: 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. Conclusion: 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. © 2024
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