6533b834fe1ef96bd129e152
RESEARCH PRODUCT
Disease-Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis
Maria P. Sormani Nicola De Rossi MdSchiavetti IreneCarmisciano LucaCordioli CinziaMoiola LuciaRadaelli MartaImmovilli PaoloCapobianco MarcoTrojano MariaZaratin PaolaTedeschi GioacchinoComi GiancarloMario A. BattagliaPatti FrancescoSalvetti MarcoNozzolillo AgostinoBellacosa AlessandraProtti Alessandra Alessia Di SapioSignori AlessioPetrone AlfredoBisecco AlvinoIovino AnielloDutto Anna Anna Maria RepiceConte AntonellaBertolotto AntonioBosco AntonioGallo AntonioZito AntonioSartori AriannaGiometto BrunoTortorella CarlaAntozzi CarloPozzilli Carlo Chiara Rosa MancinelliZanetta ChiaraCordano ChristianCordioli CinziaScandellari CinziaGuaschino ClaraGasperini ClaudioSolaro ClaudioFioretti CristinaBezzini DaianaMarastoni DamianoPaolicelli DamianoVecchio DomiziaLandi DorianaBucciantini ElisabettaPedrazzoli ElisabettaSignoriello ElisabettaSbragia Elvira Emanuela Laura SusaniCurti EricaMilano EvaMarinelli FabianaCamilli Federico Filippo Martinelli BoneschiGovone FloraBovis FrancescaCalabria FrancescaCaleri FrancescaRinaldi FrancescaVitetta FrancescaCorea FrancescoCrescenzo FrancescoPatti FrancescoTeatini FrancescoTabiadon GiuliettaGranella FrancoBoffa GiacomoLus GiacomoBrichetto GiampaoloComi GiancarloTedeschi Gioacchino Giorgia Teresa ManiscalcoBorriello GiovannaGiovanna De Luca 2Konrad GiovannaVaula Giovanna Girolama Alessandra MarfiaMallucci GiuliaLiberatore GiuseppeSalemi GiuseppeMiele GiuseppinaSibilia GraziaPesci IlariaSchiavetti IreneBrambilla LauraLopiano LeonardoSinisi LeonardoLivia PasqualiSaraceno LorenzoCarmisciano LucaChiveri LucaMancinelli LucaMoiola LuciaLuigi M. E. Grimaldi Luisa Maria CaniattiCapobianco Marco Marco Della CavaOnofrj MarcoRovaris MarcoSalvetti MarcoVercellino Marco Margherita Monti BragadinBuccafusca Maria Maria Chiara Buscarinu Maria Grazia Celani Maria Grazia Grasso Maria Laura StromilloPetracca Maria Maria Pia AmatoMaria Pia Sormani Maria Rita L'episcopoSessa Maria Maria Teresa FerròTrojano Maria Maria Vittoria ErcolaniBianco Mariangela Marianna Lo ReVianello MarikaClerico Marinella Mario Alberto Battaglia Mario Di NapoliPonzano MartaRadaelli Marta Marta Zaffira ContiCalabrese MassimilianoMirabella MassimilianoFilippi MassimoInglese MatildeLucchini MatteoPozzato Matteo Maura Chiara DanniZaffaroni MauroZampolini MauroPonzio Michela Milena De Riz Nicola De Rossi Nicola De StefanoCavalla Paola Paola De MitriGrossi PaolaZaratin PaolaConfalonieri PaoloGallo PaoloImmovilli PaoloRagonese PaoloSola PatriziaAnnovazzi PietroIaffaldano PietroNardone RaffaeleCerqua RaffaellaClerici RaffaellaLanzillo RobertaMotta RobertaBalgera RobertoBergamaschi RobertoTotaro RoccoIodice RosaCapra RuggeroMarangoni SabrinaRealmuto SabrinaCottone SalvatoreMontepietra SaraRasia SarahArena SebastianoBucello SebastianoBanfi SilviaBonavita SimonaMalucchi SimonaTonietti SimoneVollaro StefanoCordera SusannaAguglia Umberto Valentina Torri ClericiBarcella ValeriaBergamaschi Valeria Vincenzo Brescia MorraDattola Vincenzo And Vittorio Manterosubject
Male0301 basic medicineDimethyl FumarateNeurodegenerativemultiple sclerosis; coronavirus; pneumoniaSeverity of Illness Indexlaw.inventionImmunosuppressive AgentImmunologic Factor0302 clinical medicineNatalizumablawMonoclonalMultiple Sclerosi80 and overLungHumanizedResearch ArticlesAged 80 and overNatalizumabMiddle AgedIntensive care unitHospitalizationSettore MED/26 - NEUROLOGIAIntensive Care UnitsNeurologyMethylprednisoloneNeurologicalPneumonia & InfluenzaInterferonFemaleImmunosuppressive AgentsResearch ArticleHumanmedicine.drugAdultmedicine.medical_specialtyMusc-19 Study GroupMultiple SclerosisAdolescentClinical SciencesIntensive Care UnitClinical NeurologySettore MED/26Antibodies Monoclonal HumanizedAutoimmune DiseaseAntibodiesYoung Adult03 medical and health sciencesClinical ResearchInternal medicineSeverity of illnessmedicineHumansImmunologic FactorsMortalityAdolescent; Adult; Aged; Aged 80 and over; Antibodies Monoclonal Humanized; COVID-19; Dimethyl Fumarate; Female; Fingolimod Hydrochloride; Hospitalization; Humans; Immunologic Factors; Immunosuppressive Agents; Intensive Care Units; Interferons; Male; Middle Aged; Mortality; Multiple Sclerosis; Natalizumab; SARS-CoV-2; Severity of Illness Index; Young AdultAgedNeurology & NeurosurgeryExpanded Disability Status ScaleFingolimod HydrochlorideSARS-CoV-2business.industryMultiple sclerosisNeurosciencesCOVID-19PneumoniaOdds ratiomedicine.diseaseBrain DisordersGood Health and Well Being030104 developmental biologyOcrelizumabInterferonsNeurology (clinical)business030217 neurology & neurosurgerydescription
Objective: This study was undertaken to assess the impact of immunosuppressive and immunomodulatory therapies on the severity of coronavirus disease 2019 (COVID-19) in people with multiple sclerosis (PwMS). Methods: We retrospectively collected data of PwMS with suspected or confirmed COVID-19. All the patients had complete follow-up to death or recovery. Severe COVID-19 was defined by a 3-level variable: mild disease not requiring hospitalization versus pneumonia or hospitalization versus intensive care unit (ICU) admission or death. We evaluated baseline characteristics and MS therapies associated with severe COVID-19 by multivariate and propensity score (PS)-weighted ordinal logistic models. Sensitivity analyses were run to confirm the results. Results: Of 844 PwMS with suspected (n = 565) or confirmed (n = 279) COVID-19, 13 (1.54%) died; 11 of them were in a progressive MS phase, and 8 were without any therapy. Thirty-eight (4.5%) were admitted to an ICU; 99 (11.7%) had radiologically documented pneumonia; 96 (11.4%) were hospitalized. After adjusting for region, age, sex, progressive MS course, Expanded Disability Status Scale, disease duration, body mass index, comorbidities, and recent methylprednisolone use, therapy with an anti-CD20 agent (ocrelizumab or rituximab) was significantly associated (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.18–4.74, p = 0.015) with increased risk of severe COVID-19. Recent use (<1 month) of methylprednisolone was also associated with a worse outcome (OR = 5.24, 95% CI = 2.20–12.53, p = 0.001). Results were confirmed by the PS-weighted analysis and by all the sensitivity analyses. Interpretation: This study showed an acceptable level of safety of therapies with a broad array of mechanisms of action. However, some specific elements of risk emerged. These will need to be considered while the COVID-19 pandemic persists. ANN NEUROL 2021;89:780–789.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-04-01 |