COVID-19 Severity in Multiple Sclerosis

Maria Pia Sormani; Irene Schiavetti; Luca Carmisciano; Cinzia Cordioli; Massimo Filippi; Marta Radaelli; Paolo Immovilli; Marco Capobianco; Nicola De Rossi; Giampaolo Brichetto; Eleonora Cocco; Cinzia Scandellari; Paola Cavalla; Ilaria Pesci; Antonio Zito; Paolo Confalonieri; Girolama Alessandra Marfia; Paola Perini; Matilde Inglese; María Trojano; Vincenzo Brescia Morra; Gioacchino Tedeschi; Gıancarlo Comı; Mario Alberto Battaglia; Francesco Patti; Marco Salvetti; Gianmarco Abbadessa; Umberto Aguglia; Lia Allegorico; Beatrice Maria Allegri Rossi; Maria Pia Amato; Pietro Annovazzi; Carlo Antozzi; Lucia Appendino; Sebastiano Arena; Viola Baione; Roberto Balgera; Valeria Barcella; Damiano Baroncini; Caterina Barrilà; A. Bellacosa; Gianmarco Bellucci; Roberto Bergamaschi; Valeria Bergamaschi; Daiana Bezzini; Beatrice Biolzi; Alvino Bisecco; Simona Bonavita; Giovanna Borriello; Chiara Bosa; Antonio Bosco; Francesca Bovis; Marco Bozzali; Laura Brambilla; Maria Buccafusca; Elisabetta Bucciantini; Sebastiano Bucello; Maria Chiara Buscarinu; Maria Paola Cabboi; Massimiliano Calabrese; Francesca Calabria; Francesca Caleri; Federico Camilli; Luisa Caniatti; Roberto Cantello; Ruggero Capra; Rocco Capuano; Patrizia Carta; Maria Grazia Celani; Maria Cellerino; Raffaella Cerqua; Clara Grazia Chisari; Raffaella Clerici; Marinella Clerico; Gaia Cola; Antonella Conte; Marta Zaffira Conti; Christian Cordano; Susanna Cordera; Francesco Corea; Claudio Correale; Salvatore Cottone; Francesco Crescenzo; Erica Curti; Alessandro d’Ambrosio; Emanuele D’Amico; Maura Danni; Alessia d’Arma; Vincenzo Dattola; Stefano de Biase; Giovanna De Luca; Stefania Federica De Mercanti; Paolo De Mitri; Nicola De Stefano; Marco Della Cava; Mario Di Napoli; Alessia Di Sapio; Renato Docimo; A Dutto

doi:10.1212/nxi.0000000000001105

Massimo Filippi

Institution not specified

Abstract

Background and Objectives

It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19–related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population.

Methods

Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1,362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score > 3 or at least 1 comorbidity, lower risk: EDSS score ≤ 3 and no comorbidities) by the χ² test, and the risk excess was quantified by risk ratios (RRs).

Results

The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization (p < 0.001), RR = 2.19 for ICU admission (p < 0.001), and RR = 2.43 for death (p < 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04).

Discussion

Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon.

How to cite this publication

Maria Pia Sormani, Irene Schiavetti, Luca Carmisciano, Cinzia Cordioli, Massimo Filippi, Marta Radaelli, Paolo Immovilli, Marco Capobianco, Nicola De Rossi, Giampaolo Brichetto, Eleonora Cocco, Cinzia Scandellari, Paola Cavalla, Ilaria Pesci, Antonio Zito, Paolo Confalonieri, Girolama Alessandra Marfia, Paola Perini, Matilde Inglese, María Trojano, Vincenzo Brescia Morra, Gioacchino Tedeschi, Gıancarlo Comı, Mario Alberto Battaglia, Francesco Patti, Marco Salvetti, Gianmarco Abbadessa, Umberto Aguglia, Lia Allegorico, Beatrice Maria Allegri Rossi, Maria Pia Amato, Pietro Annovazzi, Carlo Antozzi, Lucia Appendino, Sebastiano Arena, Viola Baione, Roberto Balgera, Valeria Barcella, Damiano Baroncini, Caterina Barrilà, A. Bellacosa, Gianmarco Bellucci, Roberto Bergamaschi, Valeria Bergamaschi, Daiana Bezzini, Beatrice Biolzi, Alvino Bisecco, Simona Bonavita, Giovanna Borriello, Chiara Bosa, Antonio Bosco, Francesca Bovis, Marco Bozzali, Laura Brambilla, Maria Buccafusca, Elisabetta Bucciantini, Sebastiano Bucello, Maria Chiara Buscarinu, Maria Paola Cabboi, Massimiliano Calabrese, Francesca Calabria, Francesca Caleri, Federico Camilli, Luisa Caniatti, Roberto Cantello, Ruggero Capra, Rocco Capuano, Patrizia Carta, Maria Grazia Celani, Maria Cellerino, Raffaella Cerqua, Clara Grazia Chisari, Raffaella Clerici, Marinella Clerico, Gaia Cola, Antonella Conte, Marta Zaffira Conti, Christian Cordano, Susanna Cordera, Francesco Corea, Claudio Correale, Salvatore Cottone, Francesco Crescenzo, Erica Curti, Alessandro d’Ambrosio, Emanuele D’Amico, Maura Danni, Alessia d’Arma, Vincenzo Dattola, Stefano de Biase, Giovanna De Luca, Stefania Federica De Mercanti, Paolo De Mitri, Nicola De Stefano, Marco Della Cava, Mario Di Napoli, Alessia Di Sapio, Renato Docimo, A Dutto (2021). COVID-19 Severity in Multiple Sclerosis. , 9(1), DOI: https://doi.org/10.1212/nxi.0000000000001105.

COVID-19 Severity in Multiple Sclerosis

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Massimo Filippi

Abstract

Background and Objectives

Methods

Results

Discussion

How to cite this publication

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