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COVID-19 Vaccination and Disease Course in People with Multiple Sclerosis in Greece
Christos Bakirtzis1, Natalia Konstantinidou1, Sotiria Stavropoulou De Lorenzo1
1Multiple Sclerosis Center, Second Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece.
Insights
COVID-19 outcomes in people with multiple sclerosis (PwMS) show vaccination significantly reduces hospitalization risk. However, vaccination did not significantly impact mortality rates in this vulnerable population during the pandemic.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic created a global health crisis.
- Initial concerns suggested individuals with chronic conditions like multiple sclerosis (MS) faced higher risks.
- Understanding COVID-19 outcomes in people with MS (PwMS) is crucial for managing chronic diseases during pandemics.
Purpose of the Study:
- To evaluate the COVID-19 disease course in PwMS in Greece.
- To explore the impact of vaccination on SARS-CoV-2 infection outcomes in PwMS.
Main Methods:
- Retrospective analysis of anonymized nationwide administrative records (February 2020 - December 2021).
- Identification of PwMS with SARS-CoV-2 infection, collecting demographic, infection, and vaccination data.
- Study sample: 2351 PwMS (65.1% female, 51.2% unvaccinated at infection).
Main Results:
- 260 PwMS hospitalized, 25 died from COVID-19.
- Older age, male sex, and comorbidities independently increased hospitalization risk.
- Disease-modifying treatments decreased hospitalization risk; vaccination significantly protected against hospitalization.
- Age was the only significant factor for mortality; vaccination showed no significant effect on mortality.
Conclusions:
- Vaccination significantly reduces hospitalization risk for PwMS infected with SARS-CoV-2.
- While age is a significant mortality risk factor, vaccination's impact on mortality in PwMS requires further investigation.
- Disease-modifying treatments may offer protective benefits against hospitalization in PwMS.
Abstract:
Over the past three years, humanity faced the abrupt spread of COVID-19, responsible for a worldwide health crisis. Initially, it was believed that individuals with chronic disorders, including multiple sclerosis, were more likely to be infected and suffer a worse degree of COVID-19 disease. Therefore, data with regard to COVID-19 disease outcomes in these populations may provide additional insight with regard to the management of chronic diseases during viral pandemics. The objective of this study is to evaluate COVID-19 disease course in people with multiple sclerosis (PwMS) during the COVID-19 pandemic in Greece and explore the impact of vaccination in the outcome of SARS-CoV-2 infection in this population. Anonymized data, extracted from nationwide administrative records between February 2020 and December 2021, were retrospectively analyzed in order to identify PwMS with SARS-CoV-2 infection. Demographic data, as well as data regarding COVID-19 infection and vaccination, were additionally collected. The study sample included 2351 PwMS (65.1% females, 51.2% unvaccinated at the time of infection). A total of 260 PwMS were hospitalized, while 25 PwMS died from COVID-19 disease and its complications. Older age, male sex and the presence of comorbidities were independently associated with a higher probability of hospitalization. The risk of hospitalization was decreased in PwMS receiving some disease-modifying treatments. Anti-CD20s demonstrated high odds ratios without reaching statistical significance. Regarding fatal outcome, only age reached statistical significance. Vaccination provided a significant protective effect against hospitalization but did not exhibit a statistically significant effect on mortality.
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