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COVID-19 severity and outcome in multiple sclerosis: Results of a national, registry-based, matched cohort study

Carlos A Pérez1, Guo-Qiang Zhang2, Xiaojin Li2

  • 1Department of Neurology, Maxine Mesinger Multiple Sclerosis Comprehensive Care Center, Baylor College of Medicine, Houston, TX, United States.

Multiple Sclerosis and Related Disorders
|August 21, 2021
PubMed

Insights

Patients with multiple sclerosis (MS) treated with disease-modifying therapy (DMT) experienced milder coronavirus disease 2019 (COVID-19). COVID-19 severity risk in MS patients decreased over time, indicating improved outcomes.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Epidemiology

Background:

  • Previous studies identified COVID-19 severity risk factors in multiple sclerosis (MS) patients.
  • Evolving supportive care and testing capacity may influence COVID-19 outcomes in MS.
  • This study examines COVID-19 severity, outcomes, and temporal trends in US MS patients.

Purpose of the Study:

  • To evaluate COVID-19 severity and outcomes in patients with MS.
  • To characterize temporal trends in COVID-19 severity among MS patients throughout the pandemic.
  • To identify risk factors for severe COVID-19 outcomes in MS patients.

Main Methods:

  • Retrospective comparative cohort study utilizing de-identified electronic health record (EHR) claims data.
  • Matched 843 MS patients diagnosed with COVID-19 (Feb-Oct 2020) to 1,686 controls (1:2) using propensity score analysis.
  • Primary outcome: composite of intensive care unit (ICU) admission, mechanical ventilation, and/or death.

Main Results:

  • Non-ambulatory status and pre-existing comorbidities were independent risk factors for severe COVID-19.
  • The risk of the composite severe outcome was lower in later pandemic cohorts compared to earlier ones.
  • Most MS patients on disease-modifying therapy (DMT) experienced mild COVID-19.

Conclusions:

  • The majority of multiple sclerosis patients on disease-modifying therapy (DMT) experienced mild COVID-19.
  • A trend towards reduced COVID-19 severity risk suggests improving outcomes for MS patients over time.
  • Findings indicate a potential improvement in COVID-19 outcomes for MS patients as the pandemic progressed.
Abstract

Keywords:
COVID-19Disease-modifying therapyMultiple sclerosisOutcomeSARS-CoV-2

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