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Disease-modifying therapies, outcomes, risk factors and severity of COVID-19 in multiple sclerosis: A MENACTRIMS

Maya Zeineddine1, Amal Al-Hajje2, Pascale Salameh3

  • 1Inserm U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France; School of Pharmacy, Lebanese American University, Byblos, Lebanon.

Multiple Sclerosis and Related Disorders
|August 9, 2024
PubMed
Abstract

Insights

Older age, disability, obesity, and certain disease-modifying therapies like anti-CD20 treatments are risk factors for severe COVID-19 in multiple sclerosis (MS) patients. This study highlights key factors influencing COVID-19 outcomes in the MENA region.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Epidemiology

Background:

  • Limited data exists on COVID-19 risk factors in multiple sclerosis (MS) patients within the Middle East and North Africa (MENA) region.
  • Understanding these factors is crucial for managing COVID-19 in this vulnerable population.

Purpose of the Study:

  • To identify demographic, disease-related, and treatment-associated risk factors for severe COVID-19 outcomes in MS patients in the MENA region.
  • To analyze the association between disease-modifying therapies (DMTs) and COVID-19 severity in this cohort.

Main Methods:

  • A multicenter, retrospective cohort study utilizing the MENACTRIMS registry.
  • Inclusion criteria: MS patients with suspected or confirmed COVID-19.
  • Multivariate logistic regression was employed to assess risk factors for COVID-19 outcomes and severity.

Main Results:

  • 600 MS patients with COVID-19 were analyzed; 12.2% experienced severe outcomes (severity score ≥3) and 2.5% died.
  • Risk factors for moderate-to-severe COVID-19 included older age, higher disability (EDSS), obesity, and treatment with rituximab or off-label immunosuppressants.
  • A significant proportion (90.4%) of patients with severe COVID-19 were on DMTs, with 50.6% on anti-CD20 therapies.

Conclusions:

  • Age, disability (EDSS), obesity, and progressive MS are identified risk factors for severe COVID-19 in multiple sclerosis patients.
  • An association exists between exposure to anti-CD20 disease-modifying therapies and increased COVID-19 severity.
  • Findings underscore the need for targeted management strategies for MS patients during the COVID-19 pandemic.
Keywords:
COVID-19Disease-modifying therapiesMultiple sclerosisRisk factorsSeverity

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