tetano
Editor, Senior Moderator
Neurol Neuroimmunol Neuroinflamm
. 2022 Aug 29;9(6):e200021.
doi: 10.1212/NXI.0000000000200021. Print 2022 Nov.
Updated Results of the COVID-19 in MS Global Data Sharing Initiative: Anti-CD20 and Other Risk Factors Associated With COVID-19 Severity
Steve Simpson-Yap[SUP] 1 [/SUP], Ashkan Pirmani[SUP] 2 [/SUP], Tomas Kalincik[SUP] 2 [/SUP], Edward De Brouwer[SUP] 2 [/SUP], Lotte Geys[SUP] 2 [/SUP], Tina Parciak[SUP] 2 [/SUP], Anne Helme[SUP] 2 [/SUP], Nick Rijke[SUP] 2 [/SUP], Jan A Hillert[SUP] 2 [/SUP], Yves Moreau[SUP] 2 [/SUP], Gilles Edan[SUP] 2 [/SUP], Sifat Sharmin[SUP] 2 [/SUP], Tim Spelman[SUP] 2 [/SUP], Robert McBurney[SUP] 2 [/SUP], Hollie Schmidt[SUP] 2 [/SUP], Arnfin B Bergmann[SUP] 2 [/SUP], Stefan Braune[SUP] 2 [/SUP], Alexander Stahmann[SUP] 2 [/SUP], Rod M Middleton[SUP] 2 [/SUP], Amber Salter[SUP] 2 [/SUP], Bruce Bebo[SUP] 2 [/SUP], Anneke Van der Walt[SUP] 2 [/SUP], Helmut Butzkueven[SUP] 2 [/SUP], Serkan Ozakbas[SUP] 2 [/SUP], Cavit Boz[SUP] 2 [/SUP], Rana Karabudak[SUP] 2 [/SUP], Raed Alroughani[SUP] 2 [/SUP], Juan I Rojas[SUP] 2 [/SUP], Ingrid A van der Mei[SUP] 2 [/SUP], Guilherme Sciascia do Olival[SUP] 2 [/SUP], Melinda Magyari[SUP] 2 [/SUP], Ricardo N Alonso[SUP] 2 [/SUP], Richard S Nicholas[SUP] 2 [/SUP], Anibal S Chertcoff[SUP] 2 [/SUP], Ana Zabalza de Torres[SUP] 2 [/SUP], Georgina Arrambide[SUP] 2 [/SUP], Nupur Nag[SUP] 2 [/SUP], Annabel Descamps[SUP] 2 [/SUP], Lars Costers[SUP] 2 [/SUP], Ruth Dobson[SUP] 2 [/SUP], Aleisha Miller[SUP] 2 [/SUP], Paulo Rodrigues[SUP] 2 [/SUP], Vesna Prčkovska[SUP] 2 [/SUP], Giancarlo Comi[SUP] 2 [/SUP], Liesbet M Peeters[SUP] 2 [/SUP]
Affiliations
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.
. 2022 Aug 29;9(6):e200021.
doi: 10.1212/NXI.0000000000200021. Print 2022 Nov.
Updated Results of the COVID-19 in MS Global Data Sharing Initiative: Anti-CD20 and Other Risk Factors Associated With COVID-19 Severity
Steve Simpson-Yap[SUP] 1 [/SUP], Ashkan Pirmani[SUP] 2 [/SUP], Tomas Kalincik[SUP] 2 [/SUP], Edward De Brouwer[SUP] 2 [/SUP], Lotte Geys[SUP] 2 [/SUP], Tina Parciak[SUP] 2 [/SUP], Anne Helme[SUP] 2 [/SUP], Nick Rijke[SUP] 2 [/SUP], Jan A Hillert[SUP] 2 [/SUP], Yves Moreau[SUP] 2 [/SUP], Gilles Edan[SUP] 2 [/SUP], Sifat Sharmin[SUP] 2 [/SUP], Tim Spelman[SUP] 2 [/SUP], Robert McBurney[SUP] 2 [/SUP], Hollie Schmidt[SUP] 2 [/SUP], Arnfin B Bergmann[SUP] 2 [/SUP], Stefan Braune[SUP] 2 [/SUP], Alexander Stahmann[SUP] 2 [/SUP], Rod M Middleton[SUP] 2 [/SUP], Amber Salter[SUP] 2 [/SUP], Bruce Bebo[SUP] 2 [/SUP], Anneke Van der Walt[SUP] 2 [/SUP], Helmut Butzkueven[SUP] 2 [/SUP], Serkan Ozakbas[SUP] 2 [/SUP], Cavit Boz[SUP] 2 [/SUP], Rana Karabudak[SUP] 2 [/SUP], Raed Alroughani[SUP] 2 [/SUP], Juan I Rojas[SUP] 2 [/SUP], Ingrid A van der Mei[SUP] 2 [/SUP], Guilherme Sciascia do Olival[SUP] 2 [/SUP], Melinda Magyari[SUP] 2 [/SUP], Ricardo N Alonso[SUP] 2 [/SUP], Richard S Nicholas[SUP] 2 [/SUP], Anibal S Chertcoff[SUP] 2 [/SUP], Ana Zabalza de Torres[SUP] 2 [/SUP], Georgina Arrambide[SUP] 2 [/SUP], Nupur Nag[SUP] 2 [/SUP], Annabel Descamps[SUP] 2 [/SUP], Lars Costers[SUP] 2 [/SUP], Ruth Dobson[SUP] 2 [/SUP], Aleisha Miller[SUP] 2 [/SUP], Paulo Rodrigues[SUP] 2 [/SUP], Vesna Prčkovska[SUP] 2 [/SUP], Giancarlo Comi[SUP] 2 [/SUP], Liesbet M Peeters[SUP] 2 [/SUP]
Affiliations
- PMID: 36038263
- DOI: 10.1212/NXI.0000000000200021
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.