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Updated Results of the COVID-19 in MS Global Data Sharing Initiative: Anti-CD20 and Other Risk Factors Associated With COVID-19 Severity.
Simpson-Yap, Steve; Pirmani, Ashkan; Kalincik, Tomas; De Brouwer, Edward; Geys, Lotte; Parciak, Tina; Helme, Anne; Rijke, Nick; Hillert, Jan A; Moreau, Yves; Edan, Gilles; Sharmin, Sifat; Spelman, Tim; McBurney, Robert; Schmidt, Hollie; Bergmann, Arnfin B; Braune, Stefan; Stahmann, Alexander; Middleton, Rod M; Salter, Amber; Bebo, Bruce; Van der Walt, Anneke; Butzkueven, Helmut; Ozakbas, Serkan; Boz, Cavit; Karabudak, Rana; Alroughani, Raed; Rojas, Juan I; van der Mei, Ingrid A; Sciascia do Olival, Guilherme; Magyari, Melinda; Alonso, Ricardo N; Nicholas, Richard S; Chertcoff, Anibal S; de Torres, Ana Zabalza; Arrambide, Georgina; Nag, Nupur; Descamps, Annabel; Costers, Lars; Dobson, Ruth; Miller, Aleisha; Rodrigues, Paulo; Prckovska, Vesna; Comi, Giancarlo; Peeters, Liesbet M.
  • Simpson-Yap S; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Pirmani A; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Kalincik T; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • De Brouwer E; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Geys L; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Parciak T; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Helme A; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Rijke N; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Hillert JA; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Moreau Y; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Edan G; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Sharmin S; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Spelman T; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • McBurney R; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Schmidt H; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Bergmann AB; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Braune S; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Stahmann A; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Middleton RM; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Salter A; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Bebo B; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Van der Walt A; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Butzkueven H; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Ozakbas S; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Boz C; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Karabudak R; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Alroughani R; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Rojas JI; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • van der Mei IA; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Sciascia do Olival G; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Magyari M; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Alonso RN; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Nicholas RS; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Chertcoff AS; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • de Torres AZ; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Arrambide G; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Nag N; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Descamps A; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Costers L; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Dobson R; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Miller A; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Rodrigues P; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Prckovska V; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Comi G; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
  • Peeters LM; From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L
Neurol Neuroimmunol Neuroinflamm ; 9(6)2022 11.
Article in English | MEDLINE | ID: covidwho-2021402
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Certain demographic and clinical characteristics, including the use of some disease-modifying therapies (DMTs), are associated with severe acute respiratory syndrome coronavirus 2 infection severity in people with multiple sclerosis (MS). Comprehensive exploration of these relationships in large international samples is needed.

METHODS:

Clinician-reported demographic/clinical data from 27 countries were aggregated into a data set of 5,648 patients with suspected/confirmed coronavirus disease 2019 (COVID-19). COVID-19 severity outcomes (hospitalization, admission to intensive care unit [ICU], requiring artificial ventilation, and death) were assessed using multilevel mixed-effects ordered probit and logistic regression, adjusted for age, sex, disability, and MS phenotype. DMTs were individually compared with glatiramer acetate, and anti-CD20 DMTs with pooled other DMTs and with natalizumab.

RESULTS:

Of 5,648 patients, 922 (16.6%) with suspected and 4,646 (83.4%) with confirmed COVID-19 were included. Male sex, older age, progressive MS, and higher disability were associated with more severe COVID-19. Compared with glatiramer acetate, ocrelizumab and rituximab were associated with higher probabilities of hospitalization (4% [95% CI 1-7] and 7% [95% CI 4-11]), ICU/artificial ventilation (2% [95% CI 0-4] and 4% [95% CI 2-6]), and death (1% [95% CI 0-2] and 2% [95% CI 1-4]) (predicted marginal effects). Untreated patients had 5% (95% CI 2-8), 3% (95% CI 1-5), and 1% (95% CI 0-3) higher probabilities of the 3 respective levels of COVID-19 severity than glatiramer acetate. Compared with pooled other DMTs and with natalizumab, the associations of ocrelizumab and rituximab with COVID-19 severity were also more pronounced. All associations persisted/enhanced on restriction to confirmed COVID-19.

DISCUSSION:

Analyzing the largest international real-world data set of people with MS with suspected/confirmed COVID-19 confirms that the use of anti-CD20 medication (both ocrelizumab and rituximab), as well as male sex, older age, progressive MS, and higher disability are associated with more severe course of COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Multiple Sclerosis, Chronic Progressive / COVID-19 / Multiple Sclerosis Type of study: Observational study / Prognostic study Limits: Humans / Male Language: English Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Multiple Sclerosis, Chronic Progressive / COVID-19 / Multiple Sclerosis Type of study: Observational study / Prognostic study Limits: Humans / Male Language: English Year: 2022 Document Type: Article