ABSTRACT
OBJECTIVES: To gather, synthesize, and meta-analyze data regarding the risk factors associated with a severe course of COVID-19 among patients with multiple sclerosis (pwMS). METHODS: MEDLINE, Embase, Scopus, and WoS were searched in May 2021. Briefly, the eligibility criteria included: 1) studies assessing COVID-19 severity among adult pwMS; 2) definitive diagnoses or high clinical suspicion of COVID-19; 3) a categorization of COVID-19 severity into at least two categories; 4) quantitative effect size and precision measurements; and 5) English language; and 6) clear effect size/precision measures. internal validity of studies was assessed using the NIH Quality Assessment Tools. A list of possible risk factors was created based on the search results and was later used in extraction, synthesis, and meta-analysis of the data. RESULTS: Thirteen studies were included in the syntheses. Outcome measures were either extracted from the papers, obtained from the primary researchers or calculated manually. The meta-analyses showed a significantly (P<0.05) increased odds of a severe COVID-19 in pwMS with all of the assessed risk factors, except smoking and most DMTs. CONCLUSION: This study facilitates evidence-based risk/benefit assessments in practice. Older men with progressive MS on anti-CD20 therapies are more at risk of an unfortunate COVID-19 outcome.
Subject(s)
COVID-19 , Multiple Sclerosis , Adult , Aged , Humans , Male , Multiple Sclerosis/complications , Multiple Sclerosis/diagnosis , Multiple Sclerosis/epidemiology , Risk Factors , SARS-CoV-2ABSTRACT
Objectives. Clinical evidence suggests that the COVID-19 disease is more severe in the endangered populations. The purpose of this study was to investigate knowledge, attitude and practice of older people in Iran toward COVID-19 disease as a high risk group. Methods. A cross sectional study of 249 older people was conducted, using a researcher-made questionnaire. Data analysis was performed using descriptive and analytical statistics, using generalized linear model using the Gamma probability distribution model. Results. Mean scores of knowledge, attitude and practice of the older people were 92.3 ± 10.8, 89.1 ± 14.3 and 90.4 ± 13.4 respectively and were not significantly different from the sex and history of underlying diseases (p > 0.05). At generalized linear model there were no significant relationship between the older people age and their mean scores of knowledge (p > 0.05), but significant relationship between level of education and knowledge score (p < 0.001) and age and attitude, and age and practice (p < 0.5), adjusted for age > 80 years. Conclusions. This study is among the first to assess knowledge, attitudes and practice of older people toward the COVID-19 pandemic in Iran. The results indicated that the general education about the disease and follow-up of responsible organizations has been effective and these interventions need to continue.