COVID-19 Symptoms and Immunotherapy in People with Multiple Sclerosis: An Analysis of the COVID-19 in MS Global Data Sharing Initiative Dataset (preprint)

OBJECTIVESTo analyze the symptoms and severity of coronavirus disease 2019 (COVID-19) in people with multiple sclerosis (pwMS) on immunotherapy using data from the COVID-19 in multiple sclerosis (MS) Global Data Sharing Initiative dataset provided by PhysioNet. METHODSThe open-access COVID-19 in MS Global Data Sharing Initiative dataset was obtained through credentialed access using PhysioNet. The variables analyzed included body mass index (BMI), symptoms of COVID-19, age, current use of disease-modifying therapy (DMT), efficacy of DMT, comorbidities, hospitalization status, and type of MS. A linear regression analysis was completed. Data analysis and visualization were completed using STATA v1.5, R-Studio v1.1.447, Python v3.8, and its associated libraries, including NumPy, Pandas, and Matplotlib. RESULTSA total of 1141 participants were included in the analysis. 904 women and 237 men were diagnosed with MS. Among the pwMS included in the study; 208 (19.54%) had a suspected infection with COVID-19 and only 49 (5.25%) were confirmed. Any COVID-19 symptom was present in 360 individuals. The commonly reported DMT agents included dimethyl fumarate (12.71%) and fingolimod (10.17%). 101 in total (8.85%) reported not using any DMT. Factors associated with hospitalization and/or admission to the ICU included having any comorbidity (p = 0.01), neuromuscular disorder (p = 0.046), hypertension (p = 0.005), chronic kidney disease (p < 0.001), and immunodeficiency (p = 0.003). The type of MS, the duration of the disease, and high-efficacy DMT therapy did not have a statistically significant influence on hospitalization. CONCLUSIONThis study underscores the importance of comorbidities, especially neuromuscular disorders, hypertension, chronic kidney disease (CKD), and immunodeficiencies, as possible prognostic indicators for worse outcomes of COVID-19 in pwMS. On the contrary, the type of MS, the duration of the disease, and the efficacy of disease-modifying therapy did not significantly affect the severity of the symptoms of COVID-19 in this cohort.

Shifts in COVID-19 Vaccine acceptance rates among African countries: A systematic review and Meta-analysis (preprint)

Objective: To provide a comparative systematic review and meta-analysis of COVID-19 vaccine acceptance rates in African countries and their predictors. Methods: : Fifteen studies on COVID-19 vaccine acceptance rate s in African countries were reviewed in the Medline database via PubMed. Meta-analysis investigated the summary effect and inter-study heterogeneity of vaccine acceptance rates and influential factors. Results: : Overall, the COVID-19 vaccine acceptance rate was 71% (95% CI 64-77). As time passed, the vaccine acceptance rate decreased (second half of 2020: 81%, first half of 2021: 67%). Also, the vaccine acceptance rates in urban areas were higher than in rural areas (urban: 82%, rural: 72%). When considering region, vaccine acceptance rates in Eastern and Southern African countries were higher than in Western and North African countries (East: 72%, South: 72%, West: 60%, North: 52%). Finally, factors such as older age, male sex, and wealth were identified as factors associated with a more acceptive attitude toward vaccination. Conclusions: : COVID-19 vaccine acceptance rates demonstrated shifts and was affected by several factors. The rates decreased over time, were lower in rural (vs. urban) settings, and were relatively low in Northern and West African countries (vs. Southern and East African countries). We also found differences in vaccine acceptance rates by some socio-demographic characteristics. Targeting these characteristics, devising strategies to improve vaccine uptake in Africa could help improve vaccination rates.