Risk and outcomes of COVID-19 in patients with multiple sclerosis.

Autor: Moreno-Torres I; Demyelinating Diseases Unit, Jiménez Diaz Foundation University Hospital, Madrid, Spain., Meca Lallana V; Demyelinating Diseases Unit, La Princesa University Hospital, Madrid, Spain., Costa-Frossard L; Multiple Sclerosis Unit, Ramón y Cajal University Hospital, Madrid, Spain., Oreja-Guevara C; Department of Neurology, Department of Medicine, Faculty of Medicine, San Carlos Clinical Hospital, Complutense University of Madrid and San Carlos Institute for Health Research, Madrid, Spain., Aguirre C; Demyelinating Diseases Unit, La Princesa University Hospital, Madrid, Spain., Alba Suárez EM; Neuroimmunology and Multiple Sclerosis Unit, La Paz University Hospital, Madrid, Spain., Gómez Moreno M; Infanta Leonor University Hospital, Madrid, Spain., Borrega Canelo L; Alcorcón Foundation University Hospital, Madrid, Spain., Sabín Muñoz J; Neuroimmunology Unit, Puerta de Hierro University Hospital, Madrid, Spain., Aladro Y; Demyelinating Diseases Unit, University Hospital of Getafe, Madrid, Spain., Cárcamo A; Demyelinating Diseases Unit, University Hospital of Getafe, Madrid, Spain., Rodríguez García E; Severo Ochoa University Hospital, Madrid, Spain., Cuello JP; Demyelinating Diseases Unit, Gregorio Marañón General University Hospital, Madrid, Spain., Monreal E; Multiple Sclerosis Unit, Ramón y Cajal University Hospital, Madrid, Spain., Sainz de la Maza S; Multiple Sclerosis Unit, Ramón y Cajal University Hospital, Madrid, Spain., Pérez Parra F; Henares University Hospital, Madrid, Spain., Valenzuela Rojas F; Central Defense Hospital 'Gómez Ulla,', Madrid, Spain., López de Silanes de Miguel C; Torrejón University Hospital, Madrid, Spain., Casanova I; Torrejón University Hospital, Madrid, Spain., Martínez Gines ML; Demyelinating Diseases Unit, Gregorio Marañón General University Hospital, Madrid, Spain., Blasco R; Neuroimmunology Unit, Puerta de Hierro University Hospital, Madrid, Spain., Orviz García A; Demyelinating Diseases Unit, Jiménez Diaz Foundation University Hospital, Madrid, Spain., Villar-Guimerans LM; Multiple Sclerosis Unit, Ramón y Cajal University Hospital, Madrid, Spain., Fernández-Dono G; Complutense University of Madrid, Madrid, Spain., Elvira V; University of Edinburgh, Edinburgh, Scotland., Santiuste C; Multiple Sclerosis Unit, Ramón y Cajal University Hospital, Madrid, Spain., Espiño M; Multiple Sclerosis Unit, Ramón y Cajal University Hospital, Madrid, Spain., García Domínguez JM; Demyelinating Diseases Unit, Gregorio Marañón General University Hospital, Madrid, Spain.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2021 Nov; Vol. 28 (11), pp. 3712-3721. Date of Electronic Publication: 2021 Jul 18.
DOI: 10.1111/ene.14990
Abstrakt: Background and Purpose: Limited information is available on incidence and outcomes of COVID-19 in patients with multiple sclerosis (MS). This study investigated the risks of SARS-CoV-2 infection and COVID-19-related outcomes in patients with MS, and compared these with the general population.
Methods: A regional registry was created to collect data on incidence, hospitalization rates, intensive care unit admission, and death in patients with MS and COVID-19. National government outcomes and seroprevalence data were used for comparison. The study was conducted at 14 specialist MS treatment centers in Madrid, Spain, between February and May 2020.
Results: Two-hundred nineteen patients were included in the registry, 51 of whom were hospitalized with COVID-19. The mean age ± standard deviation was 45.3 ± 12.4 years, and the mean duration of MS was 11.9 ± 8.9 years. The infection incidence rate was lower in patients with MS than the general population (adjusted incidence rate ratio = 0.78, 95% confidence interval [CI] = 0.70-0.80), but hospitalization rates were higher (relative risk = 5.03, 95% CI = 3.76-6.62). Disease severity was generally low, with only one admission to an intensive care unit and five deaths. Males with MS had higher incidence rates and risk of hospitalization than females. No association was found between the use of any disease-modifying treatment and hospitalization risk.
Conclusions: Patients with MS do not appear to have greater risks of SARS-CoV-2 infection or severe COVID-19 outcomes compared with the general population. The decision to start or continue disease-modifying treatment should be based on a careful risk-benefit assessment.
(© 2021 European Academy of Neurology.)
Databáze: MEDLINE
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