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COVID-19 outcomes in patients with multiple sclerosis: Understanding changes from 2020 to 2022
Lina Jeantin1, Edouard Januel2, Pierre Labauge3
1Sorbonne University, Paris Brain Institute-ICM, Assistance Publique-Hôpitaux de Paris (AP-HP), Inserm, CNRS, Hôpital de la Pitié Salpêtrière, CIC Neurosciences, FCRIN4MS, Paris, France.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|January 22, 2024
Summary
COVID-19 severity in patients with multiple sclerosis (pwMS) decreased over time, but anti-CD20 therapies and neurological disability remained key risk factors. Vaccination significantly reduced severe outcomes in pwMS.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Previous studies on COVID-19 in patients with multiple sclerosis (pwMS) primarily covered early pandemic waves.
- Data on COVID-19 outcomes in pwMS extended to the period of widespread vaccination are limited.
Purpose of the Study:
- To analyze COVID-19 severity and risk factors in pwMS from the pandemic's onset through global vaccination coverage.
- To assess the impact of vaccination and specific therapies on COVID-19 outcomes in pwMS.
Main Methods:
- Retrospective, multicenter observational study using the COVISEP registry.
- Inclusion of confirmed or highly suspected COVID-19 cases in pwMS between January 2020 and July 2022.
- Definition of severe COVID-19 as hospitalization or higher severity.
Main Results:
- Severe COVID-19 rates in pwMS decreased significantly from 14.6% pre-Omicron to 5.7% during the Omicron wave.
- Independent risk factors for severe COVID-19 included older age, male sex, obesity, cardiac comorbidities, higher Expanded Disability Status Scale (EDSS) scores, and anti-CD20 therapies.
- Vaccination was associated with reduced COVID-19 severity in pwMS, both those on and off anti-CD20 therapies.
Conclusions:
- Anti-CD20 therapies and neurological disability (EDSS) are consistent, significant risk factors for COVID-19 severity in pwMS.
- These factors influence COVID-19 severity irrespective of the pandemic wave, time period, or vaccination status.
- Vaccination plays a crucial role in mitigating severe COVID-19 outcomes among pwMS.
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