Dataset Information

Clinical Characteristics and Outcomes in Patients With Coronavirus Disease 2019 and Multiple Sclerosis.

ABSTRACT:

Importance

Risk factors associated with the severity of coronavirus disease 2019 (COVID-19) in patients with multiple sclerosis (MS) are unknown. Disease-modifying therapies (DMTs) may modify the risk of developing a severe COVID-19 infection, beside identified risk factors such as age and comorbidities.

Objective

To describe the clinical characteristics and outcomes in patients with MS and COVID-19 and identify factors associated with COVID-19 severity.

Design, setting, and participants

The Covisep registry is a multicenter, retrospective, observational cohort study conducted in MS expert centers and general hospitals and with neurologists collaborating with MS expert centers and members of the Société Francophone de la Sclérose en Plaques. The study included patients with MS presenting with a confirmed or highly suspected diagnosis of COVID-19 between March 1, 2020, and May 21, 2020.

Exposures

COVID-19 diagnosed with a polymerase chain reaction test on a nasopharyngeal swab, thoracic computed tomography, or typical symptoms.

Main outcomes and measures

The main outcome was COVID-19 severity assessed 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). We collected demographics, neurological history, Expanded Disability Severity Scale score (EDSS; ranging from 0 to 10, with cutoffs at 3 and 6), comorbidities, COVID-19 characteristics, and outcomes. Univariate and multivariate logistic regression models were used to estimate the association of collected variables with COVID-19 outcomes.

Results

A total of 347 patients (mean [SD] age, 44.6 [12.8] years, 249 women; mean [SD] disease duration, 13.5 [10.0] years) were analyzed. Seventy-three patients (21.0%) had a COVID-19 severity score of 3 or more, and 12 patients (3.5%) died of COVID-19. The median EDSS was 2.0 (range, 0-9.5), and 284 patients (81.8%) were receiving DMT. There was a higher proportion of patients with a COVID-19 severity score of 3 or more among patients with no DMT relative to patients receiving DMTs (46.0% vs 15.5%; P < .001). Multivariate logistic regression models determined that age (odds ratio per 10 years: 1.9 [95% CI, 1.4-2.5]), EDSS (OR for EDSS ≥6, 6.3 [95% CI. 2.8-14.4]), and obesity (OR, 3.0 [95% CI, 1.0-8.7]) were independent risk factors for a COVID-19 severity score of 3 or more (indicating hospitalization or higher severity). The EDSS was associated with the highest variability of COVID-19 severe outcome (R2, 0.2), followed by age (R2, 0.06) and obesity (R2, 0.01).

Conclusions and relevance

In this registry-based cohort study of patients with MS, age, EDSS, and obesity were independent risk factors for severe COVID-19; there was no association found between DMTs exposure and COVID-19 severity. The identification of these risk factors should provide the rationale for an individual strategy regarding clinical management of patients with MS during the COVID-19 pandemic.

SUBMITTER: Louapre C

PROVIDER: S-EPMC7320356 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

Clinical Characteristics and Outcomes in Patients With Coronavirus Disease 2019 and Multiple Sclerosis.

Louapre Céline C Collongues Nicolas N Stankoff Bruno B Giannesini Claire C Papeix Caroline C Bensa Caroline C Deschamps Romain R Créange Alain A Wahab Abir A Pelletier Jean J Heinzlef Olivier O Labauge Pierre P Guilloton Laurent L Ahle Guido G Goudot Mathilde M Bigaut Kevin K Laplaud David-Axel DA Vukusic Sandra S Lubetzki Catherine C De Sèze Jérôme J Derouiche Fayçal F Tourbah Ayman A Mathey Guillaume G Théaudin Marie M Sellal François F Dugay Marie-Hélène MH Zéphir Helene H Vermersch Patrick P Durand-Dubief Françoise F Françoise Romain R Androdias-Condemine Géraldine G Pique Julie J Codjia Pékès P Tilikete Caroline C Marcaud Véronique V Lebrun-Frenay Christine C Cohen Mikael M Ungureanu Aurelian A Maillart Elisabeth E Beigneux Ysoline Y Roux Thomas T Corvol Jean-Christophe JC Bordet Amandine A Mathieu Yanica Y Le Breton Frédérique F Boulos Dalia Dimitri DD Gout Olivier O Guéguen Antoine A Moulignier Antoine A Boudot Marine M Chardain Audrey A Coulette Sarah S Manchon Eric E Ayache Samar S. SS Moreau Thibault T Garcia Pierre-Yves PY Kumaran Deiva D Castelnovo Giovanni G Thouvenot Eric E Taithe Frederic Poupart Julien J Kwiatkowski Arnaud A Defer Gilles G Derache Nathalie N Branger Pierre P Biotti Damien D Ciron Jonathan J Clerc Christine C Vaillant Mathieu M Magy Laurent L Montcuquet Alexis A Kerschen Philippe P Coustans Marc M Guennoc Anne-Marie AM Brochet Bruno B Ouallet Jean-Christophe JC Ruet Aurélie A Dulau Cécile C Wiertlewski Sandrine S Berger Eric E Buch Dan D Bourre Bertrand B Pallix-Guiot Maud M Maurousset Aude A Audoin Bertrand B Rico Audrey A Maarouf Adil A Edan Gilles G Papassin Jérémie J Videt Dorothée D

JAMA neurology 20200901 9

<h4>Importance</h4>Risk factors associated with the severity of coronavirus disease 2019 (COVID-19) in patients with multiple sclerosis (MS) are unknown. Disease-modifying therapies (DMTs) may modify the risk of developing a severe COVID-19 infection, beside identified risk factors such as age and comorbidities.<h4>Objective</h4>To describe the clinical characteristics and outcomes in patients with MS and COVID-19 and identify factors associated with COVID-19 severity.<h4>Design, setting, and pa ...[more]

PMID: 32589189

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Dataset Information

Clinical Characteristics and Outcomes in Patients With Coronavirus Disease 2019 and Multiple Sclerosis.

Importance

Objective

Design, setting, and participants

Exposures

Main outcomes and measures

Results

Conclusions and relevance

Publications

Clinical Characteristics and Outcomes in Patients With Coronavirus Disease 2019 and Multiple Sclerosis.

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