Factors associated with the severity of COVID‐19 outcomes in people with neuromuscular diseases: Data from the International Neuromuscular COVID‐19 Registry. (18th November 2022)

• Record Type: Journal Article
• Authors: Pizzamiglio, Chiara; Pitceathly, Robert D. S.; Lunn, Michael P.; Brady, Stefen; De Marchi, Fabiola; Galan, Lucia; Heckmann, Jeannine M.; Horga, Alejandro; Molnar, Maria J.; Oliveira, Acary S. B.; Pinto, Wladimir B. V. R.; Primiano, Guido; Santos, Ernestina; Schoser, Benedikt; Servidei, Serenella; Sgobbi Souza, Paulo V.; Venugopalan, Vishnu; Hanna, Michael G.; Dimachkie, Mazen M.; Machado, Pedro M.
• Other Names: Lim Albert investigator.; Elsaddig Amar investigator.; Juanatey Ana investigator.; Romeiro Ana investigator.; Themistocleous Andreas investigator.; Kiss‐Csenki Annamaria investigator.; Guerrero Sola Antonio investigator.; Patil Anuja investigator.; Duggal Ashish investigator.; Gabriel Carolyn investigator.; Marshall Charles investigator.; Record Christopher investigator.; Allen Claire investigator.; Bearden David investigator.; Rathna Sabapathi DeviPriya investigator.; R Dileep investigator.; Vecchio Domizia investigator.; Newman Edward investigator.; Eshun Edwin investigator.; Foo Eng C. investigator.; Bugiardini Enrico investigator.; Burke Georgina investigator.; Ramdharry Gita investigator.; Gorman Gràinne S. investigator.; Kumar Guru investigator.; Sivasathiaseelan Harri investigator.; Braga Farias Igor investigator.; Smuts Izelle investigator.; Holt James investigator.; Groothuis Jan T. investigator.; Pritchard Jane investigator.; Wall Jasmine investigator.; Gamez Josep investigator.; Shakthi K. J. S. investigator.; Wannop Kate investigator.; Brennan Kathryn investigator.; Saavedra Lillian investigator.; Clayton Lisa investigator.; Househam Liz investigator.; Skorupinska Mariola investigator.; Laura Matilde investigator.; Ciocca Matteo investigator.; Zosmer Maya investigator.; Dhamne Megha investigator.; Mancuso Michelangelo investigator.; Janssen Mirian investigator.; Musumeci Olimpia investigator.; Price Olivia investigator.; Chinnery Patrick F. investigator.; Ambrose Philip investigator.; Mehta Puja R. investigator.; Thomas Rhys H. investigator.; Horvath Rita investigator.; McFarland Robert investigator.; Nortley Ross investigator.; Paterson Ross W. investigator.; Geraldes Ruth investigator.; Keh Ryan investigator.; Neshuku Saara investigator.; Sasidharan Sandhya investigator.; Menon R Sarath investigator.; Raga Sharika investigator.; Rinaldi Simon investigator.; Yareeda Sireesha investigator.; Desai Soaham investigator.; Ramaratnam Sridharan investigator.; Keddie Stephen investigator.; Watson‐Fargie Taylor investigator.; Evangelista Teresinha investigator.; Sansone Valeria investigator.; Nesbitt Victoria investigator.; Macken William L. investigator.; Oktay Yavuz investigator.;
• Is Part Of: European journal of neurology. Volume 30:Number 2(2023)
• Page Start: 399
• Page End: 412
• Publication Date: 2022-11-18
• Subjects: COVID‐19 -- Guillain–Barré syndrome -- mitochondrial disease -- neuromuscular diseases -- outcome; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.15613
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract: Background and purpose: Clinical outcome information on patients with neuromuscular diseases (NMDs) who have been infected with SARS‐CoV‐2 is limited. The aim of this study was to determine factors associated with the severity of COVID‐19 outcomes in people with NMDs. Methods: Cases of NMD, of any age, and confirmed/presumptive COVID‐19, submitted to the International Neuromuscular COVID‐19 Registry up to 31 December 2021, were included. A mutually exclusive ordinal COVID‐19 severity scale was defined as follows: (1) no hospitalization; (2) hospitalization without oxygenation; (3) hospitalization with ventilation/oxygenation; and (4) death. Multivariable ordinal logistic regression analyses were used to estimate odds ratios (ORs) for severe outcome, adjusting for age, sex, race/ethnicity, NMD, comorbidities, baseline functional status (modified Rankin scale [mRS]), use of immunosuppressive/immunomodulatory medication, and pandemic calendar period. Results: Of 315 patients from 13 countries (mean age 50.3 [±17.7] years, 154 [48.9%] female), 175 (55.5%) were not hospitalized, 27 (8.6%) were hospitalized without supplemental oxygen, 91 (28.9%) were hospitalized with ventilation/supplemental oxygen, and 22 (7%) died. Higher odds of severe COVID‐19 outcomes were observed for: age ≥50 years (50–64 years: OR 2.4, 95% confidence interval [CI] 1.33–4.31; >64 years: OR 4.16, 95% CI 2.12–8.15; both vs. <50 years); non‐White race/ethnicity (OR 1.81, 95% CI 1.07–3.06; vs. White); mRS moderately severe/severe disability (OR 3.02, 95% CI 1.6–5.69; vs. no/slight/moderate disability); history of respiratory dysfunction (OR 3.16, 95% CI 1.79–5.58); obesity (OR 2.24, 95% CI 1.18–4.25); ≥3 comorbidities (OR 3.2, 95% CI 1.76–5.83; vs. ≤2; if comorbidity count used instead of specific comorbidities); glucocorticoid treatment (OR 2.33, 95% CI 1.14–4.78); and Guillain–Barré syndrome (OR 3.1, 95% CI 1.35–7.13; vs. mitochondrial disease). Conclusions: Among people with NMDs, there is a differential risk of COVID‐19 outcomes according to demographic and clinical characteristics. These findings could be used to develop tailored management strategies and evidence‐based recommendations for NMD patients.