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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

Summary: Older age, obesity, and anti-CD20 therapies raise severe COVID-19 risk in MS patients, study shows. #MultipleSclerosis #COVID19

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

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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