Updated Results of the COVID-19 in MS Global Data Sharing Initiative: Anti-CD20 and Other Risk Factors Associated With COVID-19 Severity. Issue 6 (29th November 2022)

• Record Type: Journal Article
• Authors: Simpson-Yap, Steve; Pirmani, Ashkan; Kalincik, Tomas; De Brouwer, Edward; Geys, Lotte; Parciak, Tina; Helme, Anne; Rijke, Nick; Hillert, Jan A.; Moreau, Yves; Edan, Gilles; Sharmin, Sifat; Spelman, Tim; McBurney, Robert; Schmidt, Hollie; Bergmann, Arnfin B.; Braune, Stefan; Stahmann, Alexander; Middleton, Rod M.; Salter, Amber; Bebo, Bruce; Van der Walt, Anneke; Butzkueven, Helmut; Ozakbas, Serkan; Boz, Cavit; Karabudak, Rana; Alroughani, Raed; Rojas, Juan I.; van der Mei, Ingrid A.; Sciascia do Olival, Guilherme; Magyari, Melinda; Alonso, Ricardo N.; Nicholas, Richard S.; Chertcoff, Anibal S.; de Torres, Ana Zabalza; Arrambide, Georgina; Nag, Nupur; Descamps, Annabel; Costers, Lars; Dobson, Ruth; Miller, Aleisha; Rodrigues, Paulo; Prčkovska, Vesna; Comi, Giancarlo; Peeters, Liesbet M.;
• Is Part Of: Neurology. Volume 9:Issue 6(2022)
• Publication Date: 2022-11-29
• Subjects: Neuroimmunology -- Periodicals; Neurology -- Periodicals; 616.8
• DOI: 10.1212/NXI.0000000000200021
• Languages: English
• ISSNs: 2332-7812

Abstract

Abstract : Background and Objectives: Certain demographic and clinical characteristics, including the use of some disease-modifying therapies (DMTs), are associated with severe acute respiratory syndrome coronavirus 2 infection severity in people with multiple sclerosis (MS). Comprehensive exploration of these relationships in large international samples is needed. Methods: Clinician-reported demographic/clinical data from 27 countries were aggregated into a data set of 5, 648 patients with suspected/confirmed coronavirus disease 2019 (COVID-19). COVID-19 severity outcomes (hospitalization, admission to intensive care unit [ICU], requiring artificial ventilation, and death) were assessed using multilevel mixed-effects ordered probit and logistic regression, adjusted for age, sex, disability, and MS phenotype. DMTs were individually compared with glatiramer acetate, and anti-CD20 DMTs with pooled other DMTs and with natalizumab. Results: Of 5, 648 patients, 922 (16.6%) with suspected and 4, 646 (83.4%) with confirmed COVID-19 were included. Male sex, older age, progressive MS, and higher disability were associated with more severe COVID-19. Compared with glatiramer acetate, ocrelizumab and rituximab were associated with higher probabilities of hospitalization (4% [95% CI 1–7] and 7% [95% CI 4–11]), ICU/artificial ventilation (2% [95% CI 0–4] and 4% [95% CI 2–6]), and death (1% [95% CI 0–2] and 2% [95% CI 1–4]) (predicted marginal effects). Untreated patients had 5% (95% CI 2–8), 3% (95% CI 1–5), and 1% (95% CI 0–3) higher probabilities of the 3 respective levels of COVID-19 severity than glatiramer acetate. Compared with pooled other DMTs and with natalizumab, the associations of ocrelizumab and rituximab with COVID-19 severity were also more pronounced. All associations persisted/enhanced on restriction to confirmed COVID-19. Discussion: Analyzing the largest international real-world data set of people with MS with suspected/confirmed COVID-19 confirms that the use of anti-CD20 medication (both ocrelizumab and rituximab), as well as male sex, older age, progressive MS, and higher disability are associated with more severe course of COVID-19.