Related Experiment Video

Updated: Jul 26, 2025

Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses

Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses

Published on: November 10, 2023

Association of multiple-sclerosis-related mortality with COVID-19 and other common infections: a multiple causes of

Ugo Fedeli¹, Claudio Barbiellini Amidei¹, Francesco Avossa¹

¹Epidemiological Department, Azienda Zero, Veneto Region, Italy.

European Journal of Neurology

|June 12, 2023

Abstract

Background And Purpose:

People with multiple sclerosis (MS) suffer from higher infection-related mortality compared to the general population; however, sparse data are available on the increased risk of death associated with coronavirus disease 2019 (COVID-19) and other common types of infections.

Methods:

All mortality records and multiple-cause-of-death data in 2010-2021 of residents in the Veneto region (northeastern Italy) were extracted. Mention of specific infections was compared between death certificates reporting MS or not. Odds ratios (OR) with 95% confidence intervals (95% CI) were estimated by conditional logistic regression matching by age, sex and calendar year. The bimonthly averages of MS-related deaths in 2010-2019 were compared with those registered during the pandemic (2020-2021).

Results:

Of 580,015 deaths through 2010-2021, MS was mentioned in 850 cases (0.15%), 59.3% women. Influenza and pneumonia were reported in 18.4% of MS-related compared to 11.0% non-MS-related deaths (OR 2.72, 95% CI 2.28-3.25). The odds of mention of urinary tract infections was significantly greater in MS-related deaths of men (OR 8.16, 95% CI 5.23-12.7) than women (OR 3.03, 95% CI 1.82-5.02). Aspiration pneumonia, pressure ulcers/skin infections and sepsis were also significantly associated with MS-related deaths. Reporting of COVID-19 as a cause of death did not significantly differ between deaths with and without mention of MS (approximately 11% of both). However, compared to 2010-2019, peaks in MS-related deaths were observed during the pandemic waves.

Conclusions:

Infections continue to play a significant role in MS-related deaths, underlying the need to improve prevention and management strategies.

Insights

Infections significantly increase mortality risk for multiple sclerosis (MS) patients, particularly influenza and pneumonia. While COVID-19 deaths didn't differ, MS-related deaths peaked during pandemic waves, highlighting infection management needs.

Area of Science:

Neurology
Infectious Diseases
Public Health

Background:

Multiple sclerosis (MS) patients face higher infection-related mortality than the general population.
Limited data exists on the specific risks of COVID-19 and other infections contributing to MS mortality.

Purpose of the Study:

To investigate the association between specific infections and mortality in individuals with multiple sclerosis (MS).
To compare infection-related death rates in MS patients before and during the COVID-19 pandemic.

Main Methods:

Analysis of mortality records (2010-2021) from the Veneto region, Italy.
Comparison of infection mentions on death certificates for MS versus non-MS cases.
Logistic regression to estimate odds ratios for infection-related deaths in MS patients.
Comparison of MS-related deaths during pre-pandemic (2010-2019) and pandemic (2020-2021) periods.

Main Results:

Infections were mentioned in 18.4% of MS-related deaths versus 11.0% of non-MS deaths.
Influenza and pneumonia showed significantly higher odds (OR 2.72) in MS-related deaths.
Urinary tract infections were more frequent in MS men (OR 8.16) than women (OR 3.03).
Aspiration pneumonia, skin infections, and sepsis were also linked to MS mortality.
COVID-19 as a cause of death did not significantly differ between MS and non-MS groups.
MS-related deaths showed peaks during pandemic waves compared to pre-pandemic years.

Conclusions:

Infections remain a critical factor contributing to mortality in multiple sclerosis (MS) patients.
Enhanced strategies for infection prevention and management are crucial for improving outcomes in MS.

Read full analysis

Keywords:

COVID-19 epidemiology mortality multiple sclerosis population-based study

More Related Videos

Isolating Central Nervous System Tissues and Associated Meninges for the Downstream Analysis of Immune cells

Isolating Central Nervous System Tissues and Associated Meninges for the Downstream Analysis of Immune cells

Published on: May 19, 2020

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

Published on: December 9, 2015

Related Concept Videos

Factors Affecting the Risk of Infection

Factors Affecting the Risk of Infection

The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...

Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic

Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic

Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.

Factors Affecting Illness

Factors Affecting Illness

When a person's physical, emotional, intellectual, social development or spiritual functioning is compromised, this deviation from a healthy normal state is called illness. Illness creates stress that in turn harms individuals. Irritation, anger, denial, hopelessness, and fear are behavioral and emotional changes an individual experiences in the phases of illness. A variety of factors influence a person's health and well-being.
For instance, risk factors are connected to illness,...

Rous Sarcoma Virus (RSV) and Cancer

Rous Sarcoma Virus (RSV) and Cancer

Rous Sarcoma virus or RSV was discovered by F. Peyton Rous in the year 1911 as a filterable transmissible agent that could cause tumors in chickens. He won a Nobel Prize for this discovery in 1966. His experiments clearly demonstrated that some cancers could be caused by infectious agents and led to the discovery of many more cancer-causing viruses in animals as well as humans.
RSV is a retrovirus that contains two copies of a plus-strand RNA genome. Its genome consists of four main open...

Pneumonia III: Complications and Assessment

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:

Myocarditis III: Medical Management

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...

Articles linked to this work by shared authors, journal, and citation graph.

Rising burden of inflammatory Bowel disease in Northeastern Italy: a population-based analysis of prevalence and incidence trends from 2012 to 2024.

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·2026

Toxicological analysis in sudden infant death syndrome: A call for.

Forensic science international·2026

Lymphocyte count polygenicity underlies dimethyl fumarate-associated lymphopenia in multiple sclerosis.

Multiple sclerosis (Houndmills, Basingstoke, England)·2026

Mortality Related to Different Circulatory Diseases Before, During and After the COVID-19 Pandemic.

Clinical cardiology·2026

Prevalence and Cure of Primary Liver Cancer in Italy by Histologic Type.

Cancers·2026

Emerging trends and outcomes in minimally invasive liver surgery: a population-based study in the Veneto region up to 2024 stratified by hospital case-volume.

Updates in surgery·2026

See all related articles