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SHR Neuro Cancer Cardio Lipid Metab Microb

Bsteh, G; Assar, H; Hegen, H; Heschl, B; Leutmezer, F; Di, Pauli, F; Gradl, C; Traxler, G; Zulehner, G; Rommer, P; Wipfler, P; Guger, M; Enzinger, C; Berger, T, , AUT-MuSC, investigators.
COVID-19 severity and mortality in multiple sclerosis are not associated with immunotherapy: Insights from a nation-wide Austrian registry.
PLoS One. 2021; 16(7): e0255316 Doi: 10.1371/journal.pone.0255316 [OPEN ACCESS]
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Co-authors Med Uni Graz: Enzinger Christian
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Abstract:: BACKGROUND: The COVID-19 pandemic challenges neurologists in counselling patients with multiple sclerosis (pwMS) regarding their risk by SARS-CoV-2 and in guiding disease-modifying treatment (DMT). OBJECTIVE: To characterize the prevalence and outcome of COVID-19 in pwMS specifically associated with different DMT in a nationwide population-based study. METHODS: We included patients aged ≥18 years with a confirmed diagnosis of MS and a diagnosis of COVID-19 established between January 1, 2020 and December 31, 2020. We classified COVID-19 course as either mild, severe or fatal. Impact of DMT and specifically immunosuppressants (alemtuzumab, cladribine, fingolimod, ocrelizumab or rituximab) on COVID-19 outcome was determined by multivariable models, adjusted for a-priori-risk. RESULTS: Of 126 MS patients with COVID-19 (mean age 43.2 years [SD 13.4], 71% female), 86.5% had a mild course, 9.5% a severe course and 3.2% died from COVID-19. A-priori-risk significantly predicted COVID-19 severity (R2 0.814; p<0.001) and mortality (R2 0.664; p<0.001). Adjusting for this a-priori-risk, neither exposure to any DMT nor exposure to specific immunosuppressive DMT were significantly associated with COVID-19 severity (odds ratio [OR] 1.6; p = 0.667 and OR 1.9; p = 0.426) or mortality (OR 0.5; p = 0.711 and 2.1; 0.233) when compared to no DMT. CONCLUSIONS: In a population-based MS cohort, COVID-19 outcome was not associated with exposure to DMT and immunosuppressive DMT when accounting for other already known risk factors. This provides reassuring evidence that COVID-19 risk can be individually anticipated in MS and-except for a very small proportion of high-risk patients-treatment decisions should be primarily focused on treating MS rather than the pandemic.
Find related publications in this database (using NLM MeSH Indexing): Adolescent - administration & dosage; Adult - administration & dosage; Aged - administration & dosage; Austria - epidemiology; COVID-19 - complications, epidemiology, mortality; Female - administration & dosage; Humans - administration & dosage; Immunotherapy - administration & dosage; Male - administration & dosage; Middle Aged - administration & dosage; Multiple Sclerosis - complications, immunology, therapy; Pandemics - administration & dosage; Registries - administration & dosage; Young Adult - administration & dosage