Associations of Disease-Modifying Therapies with COVID-19 Severity in Multiple Sclerosis

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MetadadosDescriçãoIdioma
Autor(es): dc.contributorand Neuroepidemiology Unit-
Autor(es): dc.contributorMelbourne School of Population and Global Health-
Autor(es): dc.contributorUniversity of Tasmania-
Autor(es): dc.contributorKU Leuven-
Autor(es): dc.contributorRoyal Melbourne Hospital-
Autor(es): dc.contributorMS International Federation-
Autor(es): dc.contributorSwedish MS Registry-
Autor(es): dc.contributorCHU Pontchaillou-
Autor(es): dc.contributorKarolinska Institutet-
Autor(es): dc.contributorHasselt University-
Autor(es): dc.contributorUniversity Medical Center-
Autor(es): dc.contributorQMENTA-
Autor(es): dc.contributorMolecular Unit-
Autor(es): dc.contributorAccelerated Cure Project for MS-
Autor(es): dc.contributorNeuroTransData-
Autor(es): dc.contributorMS Forschungs- und Projektentwicklungs-gGmbH-
Autor(es): dc.contributorSwansea University-
Autor(es): dc.contributorCOViMS-
Autor(es): dc.contributorWashington University in St. Louis-
Autor(es): dc.contributorCleveland Clinic-
Autor(es): dc.contributorMonash University-
Autor(es): dc.contributorKuwait City-
Autor(es): dc.contributorDokuz Eylul University-
Autor(es): dc.contributorHospital Universitario de CEMIC-
Autor(es): dc.contributorRELACOEM-
Autor(es): dc.contributorBulgarian SmartMS COVID-19 Dataset-
Autor(es): dc.contributorABEM-Brazilian MS Patients Association-
Autor(es): dc.contributorUniversity Hospital Rigshospitalet-
Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.contributorREDONE.br-Brazilian Registry of Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders-
Autor(es): dc.contributorIrmandade da Santa Casa de Misericórdia de São Paulo-
Autor(es): dc.contributorRamos Mejia Hospital-EMA-
Autor(es): dc.contributorImperial College-
Autor(es): dc.contributorMental Health Area-
Autor(es): dc.contributorEMA-
Autor(es): dc.contributorCemcat-
Autor(es): dc.contributorVall d'Hebron Hospital Universitari-
Autor(es): dc.contributorUniversitat Autònoma de Barcelona-
Autor(es): dc.contributorOspedale San Raffaele-
Autor(es): dc.creatorSimpson-Yap, Steve-
Autor(es): dc.creatorDe Brouwer, Edward-
Autor(es): dc.creatorKalincik, Tomas-
Autor(es): dc.creatorRijke, Nick-
Autor(es): dc.creatorHillert, Jan A.-
Autor(es): dc.creatorWalton, Clare-
Autor(es): dc.creatorEdan, Gilles-
Autor(es): dc.creatorMoreau, Yves-
Autor(es): dc.creatorSpelman, Tim-
Autor(es): dc.creatorGeys, Lotte-
Autor(es): dc.creatorParciak, Tina-
Autor(es): dc.creatorGautrais, Clement-
Autor(es): dc.creatorLazovski, Nikola-
Autor(es): dc.creatorPirmani, Ashkan-
Autor(es): dc.creatorArdeshirdavanai, Amin-
Autor(es): dc.creatorForsberg, Lars-
Autor(es): dc.creatorGlaser, Anna-
Autor(es): dc.creatorMcBurney, Robert-
Autor(es): dc.creatorSchmidt, Hollie-
Autor(es): dc.creatorBergmann, Arnfin B.-
Autor(es): dc.creatorBraune, Stefan-
Autor(es): dc.creatorStahmann, Alexander-
Autor(es): dc.creatorMiddleton, Rodden-
Autor(es): dc.creatorSalter, Amber-
Autor(es): dc.creatorFox, Robert J.-
Autor(es): dc.creatorVan Der Walt, Anneke-
Autor(es): dc.creatorButzkueven, Helmut-
Autor(es): dc.creatorAlroughani, Raed-
Autor(es): dc.creatorOzakbas, Serkan-
Autor(es): dc.creatorRojas, Juan I.-
Autor(es): dc.creatorVan Der Mei, Ingrid-
Autor(es): dc.creatorNag, Nupur-
Autor(es): dc.creatorIvanov, Rumen-
Autor(es): dc.creatorSciascia Do Olival, Guilherme-
Autor(es): dc.creatorDias, Alice Estavo-
Autor(es): dc.creatorMagyari, Melinda-
Autor(es): dc.creatorBrum, Doralina-
Autor(es): dc.creatorMendes, Maria Fernanda-
Autor(es): dc.creatorAlonso, Ricardo N.-
Autor(es): dc.creatorNicholas, Richard S.-
Autor(es): dc.creatorBauer, Johana-
Autor(es): dc.creatorChertcoff, Aníbal Sebastián-
Autor(es): dc.creatorZabalza, Anna-
Autor(es): dc.creatorArrambide, Georgina-
Autor(es): dc.creatorFidao, Alexander-
Autor(es): dc.creatorComi, Giancarlo-
Autor(es): dc.creatorPeeters, Liesbet-
Data de aceite: dc.date.accessioned2025-08-21T20:40:32Z-
Data de disponibilização: dc.date.available2025-08-21T20:40:32Z-
Data de envio: dc.date.issued2022-04-28-
Data de envio: dc.date.issued2022-04-28-
Data de envio: dc.date.issued2021-11-08-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1212/WNL.0000000000012753-
Fonte completa do material: dc.identifierhttp://hdl.handle.net/11449/222740-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/222740-
Descrição: dc.descriptionBackground and ObjectivesPeople with multiple sclerosis MS are a vulnerable group for severe coronavirus disease 2019 COVID-19, particularly those taking immunosuppressive disease-modifying therapies DMTs. We examined the characteristics of COVID-19 severity in an international sample of people with MS.MethodsData from 12 data sources in 28 countries were aggregated sources could include patients from 1-12 countries. Demographic age, sex, clinical MS phenotype, disability, and DMT untreated, alemtuzumab, cladribine, dimethyl fumarate, glatiramer acetate, interferon, natalizumab, ocrelizumab, rituximab, siponimod, other DMTs covariates were queried, along with COVID-19 severity outcomes, hospitalization, intensive care unit ICU admission, need for artificial ventilation, and death. Characteristics of outcomes were assessed in patients with suspected/confirmed COVID-19 using multilevel mixed-effects logistic regression adjusted for age, sex, MS phenotype, and Expanded Disability Status Scale EDSS score.ResultsSix hundred fifty-seven 28.1% with suspected and 1,683 61.9% with confirmed COVID-19 were analyzed. Among suspected plus confirmed and confirmed-only COVID-19, 20.9% and 26.9% were hospitalized, 5.4% and 7.2% were admitted to ICU, 4.1% and 5.4% required artificial ventilation, and 3.2% and 3.9% died. Older age, progressive MS phenotype, and higher disability were associated with worse COVID-19 outcomes. Compared to dimethyl fumarate, ocrelizumab and rituximab were associated with hospitalization adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI] 1.01-2.41; aOR 2.43, 95% CI 1.48-4.02 and ICU admission aOR 2.30, 95% CI 0.98-5.39; aOR 3.93, 95% CI 1.56-9.89, although only rituximab was associated with higher risk of artificial ventilation aOR 4.00, 95% CI 1.54-10.39. Compared to pooled other DMTs, ocrelizumab and rituximab were associated with hospitalization aOR 1.75, 95% CI 1.29-2.38; aOR 2.76, 95% CI 1.87-4.07 and ICU admission aOR 2.55, 95% CI 1.49-4.36; aOR 4.32, 95% CI 2.27-8.23, but only rituximab was associated with artificial ventilation aOR 6.15, 95% CI 3.09-12.27. Compared to natalizumab, ocrelizumab and rituximab were associated with hospitalization aOR 1.86, 95% CI 1.13-3.07; aOR 2.88, 95% CI 1.68-4.92 and ICU admission aOR 2.13, 95% CI 0.85-5.35; aOR 3.23, 95% CI 1.17-8.91, but only rituximab was associated with ventilation aOR 5.52, 95% CI 1.71-17.84. Associations persisted on restriction to confirmed COVID-19 cases. No associations were observed between DMTs and death. Stratification by age, MS phenotype, and EDSS score found no indications that DMT associations with COVID-19 severity reflected differential DMT allocation by underlying COVID-19 severity.DiscussionUsing the largest cohort of people with MS and COVID-19 available, we demonstrated consistent associations of rituximab with increased risk of hospitalization, ICU admission, and need for artificial ventilation and of ocrelizumab with hospitalization and ICU admission. Despite the cross-sectional design of the study, the internal and external consistency of these results with prior studies suggests that rituximab/ocrelizumab use may be a risk factor for more severe COVID-19.-
Descrição: dc.descriptionCORe Department of Medicine and Neuroepidemiology Unit-
Descrição: dc.descriptionMelbourne School of Population and Global Health-
Descrição: dc.descriptionMenzies Institute for Medical Research University of Tasmania-
Descrição: dc.descriptionESAT-STADIUS KU Leuven-
Descrição: dc.descriptionDepartment of Neurology Melbourne MS Centre Royal Melbourne Hospital-
Descrição: dc.descriptionMS International Federation-
Descrição: dc.descriptionDepartment of Clinical Neuroscience Swedish MS Registry-
Descrição: dc.descriptionDepartment of Neurology CHU Pontchaillou-
Descrição: dc.descriptionKarolinska Institutet-
Descrição: dc.descriptionBiomedical Research Institute-Data Science Institute Hasselt University-
Descrição: dc.descriptionDepartment of Medical Informatics University Medical Center-
Descrição: dc.descriptionDepartment of Computer Science and AI KU Leuven-
Descrição: dc.descriptionQMENTA-
Descrição: dc.descriptionMedpace Reference Laboratories Molecular Unit-
Descrição: dc.descriptionIConquerMS People-Powered Research Network Accelerated Cure Project for MS-
Descrição: dc.descriptionNeuroTransData Study Group NeuroTransData-
Descrição: dc.descriptionGerman MS-Register by the National MS Society MS Forschungs- und Projektentwicklungs-gGmbH-
Descrição: dc.descriptionMS Register Swansea University-
Descrição: dc.descriptionCOViMS-
Descrição: dc.descriptionDivision of Biostatistics Washington University in St. Louis-
Descrição: dc.descriptionMellen Center for Multiple Sclerosis Cleveland Clinic-
Descrição: dc.descriptionDepartment of Neuroscience Central Clinical School Monash University-
Descrição: dc.descriptionAl-Amiri Hospital Kuwait City-
Descrição: dc.descriptionDokuz Eylul University-
Descrição: dc.descriptionNeurology Department Hospital Universitario de CEMIC-
Descrição: dc.descriptionRELACOEM-
Descrição: dc.descriptionAustralian MS Longitudinal Study Menzies Institute for Medical Research University of Tasmania-
Descrição: dc.descriptionBulgarian SmartMS COVID-19 Dataset-
Descrição: dc.descriptionABEM-Brazilian MS Patients Association-
Descrição: dc.descriptionDanish Multiple Sclerosis Registry Department of Neurology University Hospital Rigshospitalet-
Descrição: dc.descriptionUniversidade Estadual Paulista Unesp Faculdade de Medicina-
Descrição: dc.descriptionREDONE.br-Brazilian Registry of Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders-
Descrição: dc.descriptionIrmandade da Santa Casa de Misericórdia de São Paulo-
Descrição: dc.descriptionMultiple Sclerosis University Center Ramos Mejia Hospital-EMA-
Descrição: dc.descriptionImperial College-
Descrição: dc.descriptionSwansea University-
Descrição: dc.descriptionMental Health Area-
Descrição: dc.descriptionMS and Demyelinating Diseases Hospital Británico de Buenos Aires EMA-
Descrição: dc.descriptionServei de Neurologia-Neuroimmunologia Centre d'Esclerosi Múltiple de Catalunya Cemcat-
Descrição: dc.descriptionVall d'Hebron Institut de Recerca Vall d'Hebron Hospital Universitari-
Descrição: dc.descriptionUniversitat Autònoma de Barcelona-
Descrição: dc.descriptionInstitute of Experimental Neurology Ospedale San Raffaele-
Descrição: dc.descriptionUniversidade Estadual Paulista Unesp Faculdade de Medicina-
Formato: dc.formatE1870-E1885-
Idioma: dc.languageen-
Relação: dc.relationNeurology-
???dc.source???: dc.sourceScopus-
Título: dc.titleAssociations of Disease-Modifying Therapies with COVID-19 Severity in Multiple Sclerosis-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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