학술논문
Disease‐Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis
Document Type
article
Author
Sormani, Maria P; De Rossi, Nicola; Schiavetti, Irene; Carmisciano, Luca; Cordioli, Cinzia; Moiola, Lucia; Radaelli, Marta; Immovilli, Paolo; Capobianco, Marco; Trojano, Maria; Zaratin, Paola; Tedeschi, Gioacchino; Comi, Giancarlo; Battaglia, Mario A; Patti, Francesco; Salvetti, Marco; Nozzolillo, Agostino; Bellacosa, Alessandra; Protti, Alessandra; Di Sapio, Alessia; Signori, Alessio; Petrone, Alfredo; Bisecco, Alvino; Iovino, Aniello; Dutto, Anna; Repice, Anna Maria; Conte, Antonella; Bertolotto, Antonio; Bosco, Antonio; Gallo, Antonio; Zito, Antonio; Sartori, Arianna; Giometto, Bruno; Tortorella, Carla; Antozzi, Carlo; Pozzilli, Carlo; Mancinelli, Chiara Rosa; Zanetta, Chiara; Cordano, Christian; Scandellari, Cinzia; Guaschino, Clara; Gasperini, Claudio; Solaro, Claudio; Fioretti, Cristina; Bezzini, Daiana; Marastoni, Damiano; Paolicelli, Damiano; Vecchio, Domizia; Landi, Doriana; Bucciantini, Elisabetta; Pedrazzoli, Elisabetta; Signoriello, Elisabetta; Sbragia, Elvira; Susani, Emanuela Laura; Curti, Erica; Milano, Eva; Marinelli, Fabiana; Camilli, Federico; Boneschi, Filippo Martinelli; Govone, Flora; Bovis, Francesca; Calabria, Francesca; Caleri, Francesca; Rinaldi, Francesca; Vitetta, Francesca; Corea, Francesco; Crescenzo, Francesco; Teatini, Francesco; Tabiadon, Giulietta; Granella, Franco; Boffa, Giacomo; Lus, Giacomo; Brichetto, Giampaolo; Maniscalco, Giorgia Teresa; Borriello, Giovanna; De Luca, Giovanna; Konrad, Giovanna; Vaula, Giovanna; Marfia, Girolama Alessandra; Mallucci, Giulia; Liberatore, Giuseppe; Salemi, Giuseppe; Miele, Giuseppina; Sibilia, Grazia; Pesci, Ilaria; Brambilla, Laura; Lopiano, Leonardo; Sinisi, Leonardo; Pasquali, Livia; Saraceno, Lorenzo; Chiveri, Luca; Mancinelli, Luca; Grimaldi, Luigi ME
Source
Annals of Neurology. 89(4)
Subject
Language
Abstract
ObjectiveThis study was undertaken to assess the impact of immunosuppressive and immunomodulatory therapies on the severity of coronavirus disease 2019 (COVID-19) in people with multiple sclerosis (PwMS).MethodsWe retrospectively collected data of PwMS with suspected or confirmed COVID-19. All the patients had complete follow-up to death or recovery. Severe COVID-19 was defined by a 3-level variable: mild disease not requiring hospitalization versus pneumonia or hospitalization versus intensive care unit (ICU) admission or death. We evaluated baseline characteristics and MS therapies associated with severe COVID-19 by multivariate and propensity score (PS)-weighted ordinal logistic models. Sensitivity analyses were run to confirm the results.ResultsOf 844 PwMS with suspected (n = 565) or confirmed (n = 279) COVID-19, 13 (1.54%) died; 11 of them were in a progressive MS phase, and 8 were without any therapy. Thirty-eight (4.5%) were admitted to an ICU; 99 (11.7%) had radiologically documented pneumonia; 96 (11.4%) were hospitalized. After adjusting for region, age, sex, progressive MS course, Expanded Disability Status Scale, disease duration, body mass index, comorbidities, and recent methylprednisolone use, therapy with an anti-CD20 agent (ocrelizumab or rituximab) was significantly associated (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.18-4.74, p = 0.015) with increased risk of severe COVID-19. Recent use (