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A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
SARS-CoV-2 infection increases long-term multiple sclerosis disease activity and all-cause mortality in an
Roham Hadidchi1, Stephen H Wang2, David Rezko1
1Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA; Center for Health & Data Innovation, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
Background:
Although certain subsets patients with multiple sclerosis (MS), an immune-mediated disorder, are at higher risk of worse acute COVID-19 outcomes compared to the general population, it is not clear whether SARS-CoV-2 infection impacts long-term outcomes compared with MS patients without COVID-19 infection.
Objectives:
This study investigated MS disease activity and mortality 3.5 years post SARS-CoV-2 infection and compared with MS patients without COVID-19.
Methods:
This retrospective study evaluated 1,633 patients with MS in the Montefiore Health System in the Bronx from January 2016 to July 2023. This health system serves a large minority population and was an epicenter for the early pandemic and subsequent surges of infection. Positive SARS-CoV-2 infection was determined by a positive polymerase-chain-reaction test. Primary outcomes were all-cause mortality, and optic neuritis post SARS-CoV-2 infection. Secondary outcomes included change in disease-modifying therapy (DMT), treatment with high-dose methylprednisolone, cerebellar deficits, relapse, and all-cause hospitalization post-infection.
Results:
MS patients with COVID-19 had similar demographics but higher prevalence of pre-existing major comorbidities (hypertension, type-2 diabetes, chronic obstructive pulmonary disease, congestive heart failure, chronic kidney disease, and coronary artery disease), optic neuritis, and history of high dose steroid treatment for relapses compared to MS patients without COVID-19. MS patients with COVID-19 had greater risk of mortality (adjusted HR=4.34[1.67, 11.30], p < 0.005), greater risk of post infection optic neuritis (adjusted HR=2.97[1.58, 5.58], p < 0.005), higher incidence of methylprednisolone treatment for post infection acute relapse (12.65% vs. 2.54 %, p < 0.001), and more hospitalization (78.92% vs. 66.81 %, p < 0.01), compared to MS patients without COVID-19.
Conclusions:
MS patients who survived COVID-19 infection experienced worse long-term outcomes, as measured by treatment for relapse, hospitalization and mortality. Identifying risk factors for worse long-term outcomes may draw clinical attention to the need for careful follow-up of at-risk individuals post-SARS-CoV-2 infection.
Insights
Multiple sclerosis (MS) patients who contracted COVID-19 faced worse long-term outcomes, including increased mortality and optic neuritis. Careful follow-up is crucial for these individuals post-SARS-CoV-2 infection.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Multiple sclerosis (MS) is an immune-mediated disorder.
- While some MS patients face higher acute COVID-19 risks, long-term outcomes post-SARS-CoV-2 infection remain unclear.
- This study addresses the long-term impact of COVID-19 on MS patients.
Purpose of the Study:
- To investigate MS disease activity and mortality 3.5 years after SARS-CoV-2 infection.
- To compare outcomes in MS patients with and without a history of COVID-19.
Main Methods:
- Retrospective study of 1,633 MS patients from January 2016 to July 2023.
- SARS-CoV-2 infection confirmed by polymerase-chain-reaction test.
- Primary outcomes: all-cause mortality and optic neuritis; Secondary outcomes: disease-modifying therapy changes, high-dose methylprednisolone treatment, relapse, and hospitalization.
Main Results:
- MS patients with COVID-19 had higher rates of comorbidities, optic neuritis, and steroid treatment for relapses.
- COVID-19 survivors experienced significantly greater risk of mortality (adjusted HR=4.34)
- Increased risk of post-infection optic neuritis (adjusted HR=2.97), relapse treatment, and hospitalization compared to MS patients without COVID-19.
Conclusions:
- COVID-19 infection is associated with worse long-term outcomes in multiple sclerosis patients.
- Outcomes include increased relapse treatment, hospitalization, and mortality.
- Identifying at-risk individuals necessitates careful post-SARS-CoV-2 follow-up.
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