Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS)

Clinical Characteristics and Outcomes in Patients with Coronavirus Disease 2019 and Multiple Sclerosis

Research Alert

Newswise — Background: Risk factors associated with the severity of COVID-19 in patients with multiple sclerosis (MS) begin to be identified from several cohort studies. Disease modifying therapies (DMTs) may modify the risk of developing a severe COVID-19 infection, beside identified risk factors such as age and comorbidities.

Objectives: The objective was to describe the clinical characteristics and outcomes in patients with COVID-19 and to identify the factors associated with COVID-19 severity.

Methods: This multicenter, retrospective, observational cohort study (COVISEP registry, NCT04355611) included patients with MS presenting with a confirmed or highly suspected diagnosis of COVID-19 between March 1, 2020 and July 14, 2020. The main outcome was COVID-19 severity assessed on a 7-point ordinal scale (ranging from 1: not hospitalized, no limitations on activities, to 7: death; cutoff at 3: hospitalized, not requiring supplemental oxygen). We collected demographics, neurological history, Expanded Disability Severity Score (EDSS), comorbidities, COVID-19 characteristics and outcome. Univariate and multivariate logistic regression models were used to estimate the influence of collected variables on COVID-19 outcome.

Results: A total of 405 patients (mean age: 44.7 years, female/male: 293/112, mean disease duration: 13.4 years) were analyzed. Seventy-eight patients (19.3%) had a COVID-19 severity score ≥ 3, and 12 patients (3.0%) died from COVID-19. Median EDSS was 2.0 (range: 0-9.5), 326 patients (80.5%) were on DMT. There was a higher proportion of patients with COVID-19 severity score ≥ 3 among patients with no DMT relative to patients on DMTs (39.2% versus 14.4%, p<0.001). Multivariate logistic regression models determined that age (OR for 10 years: 1.8, 95% CI: 1.4-2.4), EDSS (OR for EDSS ≥ 6: 4.5, 95% CI: 2.0-10.0) were independent risk factors for COVID-19 severity score ≥ 3 (hospitalization or higher severity) while immunomodulatory treatment (interferon or glatiramer acetate) was associated with lower risk of COVID-19 severity score ≥ 3 (OR: 0.2, 95% CI: 0.05-0.8). EDSS was associated with the highest variability of COVID-19 severe outcome (R2= 0.18), followed by age (R2= 0.06) and immunomodulatory treatment (R2= 0.02).

Conclusions: EDSS and age were independent risk factors of severe COVID-19, while exposure to immunomodulatory DMTs (interferon and glatiramer acetate) were independently associated with lower COVID-19 severity. We did not find an association between other DMTs exposure (including immunosuppressive therapies) and COVID-19 severity. The identification of these risk factors should provide the rationale for an individual strategy regarding clinical management of MS patients during the COVID-19 pandemic.

Presenter: Celine Louapre, Pitié-Salpêtrière hospital, APHP, Neurology

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Released: 28-Oct-2020 3:20 AM EDT
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Embargo will expire: 28-Oct-2020 3:10 PM EDT Released to reporters: 27-Oct-2020 2:05 PM EDT

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Released: 27-Oct-2020 12:05 PM EDT
Rush Preparing for COVID-19 Resurgence
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With Chicago and Illinois seeing a surge in cases of COVID-19 and the city and state implementing new restrictions to lessen the spread of the disease, Rush University System for Health is preparing for a resurgence of cases. Rush will continue to diligently prepare and plan its response to the surge to ensure the safety of everyone in Rush hospitals and clinics and within the Rush community.

Released: 27-Oct-2020 11:55 AM EDT
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Which is more important in the initial phase of a pandemic: taking precautionary actions or responding to its severity? That is the question that researchers from the Singapore University of Technology and Design (SUTD) set out to address in an article published in BioEssays.

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