COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Sormani, Maria Pia; Schiavetti, Irene; Carmisciano, Luca; Cordioli, Cinzia; Filippi, Massimo; Radaelli, Marta; Immovilli, Paolo; Capobianco, Marco; De Rossi, Nicola; Brichetto, Giampaolo; Cocco, Eleonora; Scandellari, Cinzia; Cavalla, Paola; Pesci, Ilaria; Zito, Antonio; Confalonieri, Paolo; Marfia, Girolama Alessandra; Perini, Paola; Inglese, Matilde; Trojano, Maria; Brescia Morra, Vincenzo; Tedeschi, Gioacchino; Comi, Giancarlo; Battaglia, Mario Alberto; Patti, Francesco; Salvetti, Marco; Abbadessa, Gianmarco; Aguglia, Umberto; Allegorico, Lia; Allegri Rossi, Beatrice Maria; Amato, Maria Pia; Annovazzi, Pietro; Antozzi, Carlo; Appendino, Lucia; Arena, Sebastiano; Baione, Viola; Balgera, Roberto; Barcella, Valeria; Baroncini, Damiano; Barrilà, Caterina; Bellacosa, Alessandra; Bellucci, Gianmarco; Bergamaschi, Roberto; Bergamaschi, Valeria; Bezzini, Daiana; Biolzi, Beatrice; Bisecco, Alvino; Bonavita, Simona; Borriello, Giovanna; Bosa, Chiara; Bosco, Antonio; Bovis, Francesca; Bozzali, Marco; Brambilla, Laura; Buccafusca, Maria; Bucciantini, Elisabetta; Bucello, Sebastiano; Buscarinu, Maria Chiara; Cabboi, Maria Paola; Calabrese, Massimiliano; Calabria, Francesca; Caleri, Francesca; Camilli, Federico; Caniatti, Luisa Maria; Cantello, Roberto; Capra, Ruggero; Capuano, Rocco; Carta, Patrizia; Celani, Maria Grazia; Cellerino, Maria; Cerqua, Raffaella; Chisari, Clara; Clerici, Raffaella; Clerico, Marinella; Cola, Gaia; Conte, Antonella; Conti, Marta Zaffira; Cordano, Christian; Cordera, Susanna; Corea, Francesco; Correale, Claudio; Cottone, Salvatore; Crescenzo, Francesco; Curti, Erica; d'Ambrosio, Alessandro; D'Amico, Emanuele; Danni, Maura Chiara; d'Arma, Alessia; Dattola, Vincenzo; de Biase, Stefano; Luca, Giovanna De; Mercanti, Stefania Federica De; De Mitri, Paolo; De Stefano, Nicola; Cava, Marco Della; Napoli, Mario di; Sapio, Alessia Di; Docimo, Renato; Dutto, Anna; Evangelista, Luana; Fanara, Salvatore; Diana, Ferraro; Ferrò, Maria Teresa; Fioretti, Cristina; Fratta, Mario; Frau, Jessica; Fronza, Marzia; Furlan, Roberto; Gajofatto, Alberto; Gallo, Antonio; Gallo, Paolo; Gasperini, Claudio; Ghazaryan, Anna; Giometto, Bruno; Gobbin, Francesca; Govone, Flora; Granella, Franco; Grange, Erica; Grasso, Maria Grazia; Guareschi, Angelica; Guaschino, Clara; Guerrieri, Simone; Guidetti, Donata; Iaffaldano, Pietro; Ianniello, Antonio; Iasevoli, Luigi; Imperiale, Daniele; Infante, Maria Teresa; Iodice, Rosa; Iovino, Aniello; Konrad, Giovanna; Landi, Doriana; Lanzillo, Roberta; Lapucci, Caterina; Lavorgna, Luigi; L'Episcopo, Maria Rita; Leva, Serena; Liberatore, Giuseppe; Lo Re, Marianna; Longoni, Marco; Lopiano, Leonardo; Lorefice, Lorena; Lucchini, Matteo; Lus, Giacomo; Maimone, Davide; Malentacchi, Maria; Mallucci, Giulia; Malucchi, Simona; Mancinelli, Chiara Rosa; Mancinelli, Luca; Manganotti, Paolo; Maniscalco, Giorgia Teresa; Mantero, Vittorio; Marangoni, Sabrina; Marastoni, Damiano; Marinelli, Fabiana; Marti, Alessandro; Boneschi, Filippo Martinelli; Masserano Zoli, Federco; Matta, Francesca; Mendozzi, Laura; Meucci, Giuseppe; Miante, Silvia; Miele, Giuseppina; Milano, Eva; Mirabella, Massimiliano; Missione, Rosanna; Moccia, Marcello; Moiola, Lucia; Montepietra, Sara; MontiBragadin, Margherita; Montini, Federico; Motta, Roberta; Nardone, Raffaele; Nicoletti, Carolina Gabri; Nobile-Orazio, Eduardo; Nozzolillo, Agostino; Onofrj, Marco; Orlandi, Riccardo; Palmieri, Anna; Paolicelli, Damiano; Pasquali, Livia; Pastò, Luisa; Pedrazzoli, Elisabetta; Petracca, Maria; Petrone, Alfredo; Piantadosi, Carlo; Pietroboni, Anna M; Pinardi, Federica; Ponzano, Marta; Portaccio, Emilio; Pozzato, Mattia; Pozzilli, Carlo; Prosperini, Luca; Protti, Alessandra; Ragonese, Paolo; Rasia, Sarah; Realmuto, Sabrina; Repice, Anna; Rigoni, Eleonora; Rilla, Maria Teresa; Rinaldi, Francesca; Romano, Calogero Marcello; Ronzoni, Marco; Rovaris, Marco; Ruscica, Francesca; Sabattini, Loredana; Salemi, Giuseppe; Saraceno, Lorenzo; Sartori, Alessia; Sartori, Arianna; Sbragia, Elvira; Scarano, Giuditta Ilaria; Scarano, Valentina; Schillaci, Valentina; Sessa, Maria; Sgarito, Caterina; Sibilia, Grazia; Siciliano, Gabriele; Signori, Alessio; Signoriello, Elisabetta; Sinisi, Leonardo; Sireci, Francesca; Sola, Patrizia; Solaro, Claudio; Sotgiu, Stefano; Sparaco, Maddalena; Stromillo, Maria Laura; Strumia, Silvia; Susani, Emanuela Laura; Tabiadon, Giulietta; Teatini, Francesco; Tomassini, Valentina; Tonietti, Simone; Torri, Clerici Valentina; Tortorella, Carla; Toscano, Simona; Totaro, Rocco; Trotta, Maria; Turano, Gabriella; Ulivelli, Monica; Valentino, Manzo; Vaula, Giovanna; Vecchio, Domizia; Vercellino, Marco; Verrengia, Elena Pinuccia; Vianello, Marika; Virgilio, Eleonora; Vitetta, Francesca; Vollaro, Stefano; Zaffaroni, Mauro; Zampolini, Mauro; Zarbo, Ignazio Roberto; Zuliani, Luigi;
• Is Part Of: Neurology. Volume 9:Issue 1(2022)
• Publication Date: 2022-01
• Subjects: Neuroimmunology -- Periodicals; Neurology -- Periodicals; 616.8
• DOI: 10.1212/NXI.0000000000001105
• Languages: English
• ISSNs: 2332-7812

Abstract

Abstract : Background and Objectives: It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19–related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population. Methods: Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1, 362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score > 3 or at least 1 comorbidity, lower risk: EDSS score ⩽ 3 and no comorbidities) by the χ 2 test, and the risk excess was quantified by risk ratios (RRs). Results: The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization ( p < 0.001), RR = 2.19 for ICU admission ( p < 0.001), and RR = 2.43 for death ( p < 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04). Discussion: Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon.