ABSTRACT
Background: People with multiple sclerosis (MS) are a vulnerable group for severe COVID-19, particularly those taking immunosuppressive disease-modifying therapies (DMTs). Objective(s): To assess characteristics of COVID-19 severity in an international sample of people with MS, including hospitalisation, ICU admission, requiring artificial ventilation, and death. Method(s): Data from 12 data-sources in 28 countries were aggregated. Demographic and clinical covariates were queried, alongside COVID-19 clinical severity outcomes, hospitalisation, admission to ICU, requiring artificial ventilation, and death. Characteristics of outcomes were assessed in patients with suspected/ confirmed COVID-19 using multilevel mixed-effects logistic regression. Result(s): 657 (28.1%) with suspected and 1,683 (61.9%) with confirmed COVID-19. Older age, progressive MS-phenotype, and higher disability associated with worse COVID-19 outcomes. Ocrelizumab and rituximab associated with hospitalisation (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) vs pooled-other-DMTs but only rituximab with artificial ventilation (aOR=6.15,95%CI=3.09-12.27). Similar associations seen compared to dimethyl fumarate and to natalizumab. No associations observed between DMTs and death. Conclusion(s): Using the largest cohort of people with MS and COVID-19 available, we demonstrated consistent associations of rituximab and ocrelizumab with worse COVID-19, suggesting their use may be a risk factor for more severe COVID-19.
ABSTRACT
Background and Aim: The objective of the study was to assess the features of acute myocarditis and compare Covid19 and non-Covid19 cases. Method(s): Patients lt;18y with acute myocarditis (proved by virology and/or MRI and/or complete recovery of myocardial function) were included. Clinical data, echocardiographic parameters and outcomes were collected. Cases were divided in groups I (non-Covid), II (Covid). Result(s): From 1983 to 2021, 139 patients were included: 76 patients in group I and 63 in group II, 67males (31 in group I = 40% vs 36 in II = 57%). Mean age at diagnosis was 6.8 years: 4.2 years in group I vs 9.9 years in II. Heart failure (HF) was present at onset in 78% of cases in group I and 50% in group II: severe HF was more frequent in group I, chest pain was more frequent in II. Mean left ventricular shortening fraction (LVSF) at diagnosis was 23.8%: 18.4% in groups I vs 31.6% in II (plt;0.05). Mitral regurgi-tation was present in 63.8% of cases = 76.5% vs 43.8% respectively in groups I and II, pericarditis in 16.4% (no difference between groups), thromboembolic events occurred in 7% and arrhythmias in 10% ((all in group I). Virus was positive in 37.5% in group I and SARS-Cov2 positive in all of group II. Inotrope support was needed in 47%, mechanical circulatory support in 8% in group I only. Eleven patients died in group I, no death occurred in group II. One was transplanted(3rdmonth) and 19 have sequellae in group I. Complete recovery occurred in 74% of all cases: 40 of group I (58%) and all of group II (100%): time to recovery was longer in group I (2 years) than in group I (2 weeks). Mean LVSF improved from 18.4% at onset, to 24.6% at 1st month, 26.5% at 3rd month, 30.7% at 6th month and 38% at last FU in group I, while mean LVSF normalized within 2 weeks after onset in group II. Conclusion(s): Myocardial dysfunction and heart failure were less fre-quent, and complete recovery occurred promptly in COVID cases, while myocardial improvement progressed slowly within first 6months and beyond in half of non-COVID cases.
ABSTRACT
Aim: The Fear of COVID-19 Scale is a widely used measurement tool for related anxieties, however previous studies validating the scale report varying fit indices, often below accepted cut-off points. This suggests re-specification of the scale may be required. The present study aimed to examine the psychometric properties of the English-version of the Fear of COVID-19 Scale in a population of help-seeking males using exploratory (EFA) and confirmatory factor analysis (CFA). Material and methods: Data from 621 males aged 18-80 years (mean=38.23, SD=13.59) was collected via a cross-sectional open online survey. Along with the 7-item Fear of COVID-19 Scale, the PHQ-4 and PROMIS Anger Short Form were used to measure probable anxiety, depression and anger. Data were randomly partitioned into two subsamples and separate factor analyses were conducted with robust CFA corrections applied for non-normality. Results: A 4-item single-factor version of the scale was identified reporting excellent model fit (R-RMSEA=.033, R-CFI=.998, R-TFI=.997, SRMR=.012) and good internal consistency (α=.86). Age and probable anxiety effects were observed. Discussion: Relative to existing validation studies of the Fear of COVID-19 Scale, the present study provides improved psychometrics of the 4-item version of the scale, while scale means observed were comparable to other studies. Conclusion: This study validates a 4-item version of the Fear of COVID-19 Scale to assess related anxieties in a help seeking male population. Future research should seek to validate the 4-item version in other subpopulations. © 2022 Polish Psychiatric Association. All rights reserved.