Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Alzahra Research Institute, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran; Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Isfahan, Iran.
Rev Neurol (Paris). 2022 Jan-Feb;178(1-2):121-128. doi: 10.1016/j.neurol.2021.10.003. Epub 2021 Nov 4.
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).
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.
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.
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.
收集、综合和荟萃分析与多发性硬化症（pwMS）患者 COVID-19 严重程度相关的风险因素的数据。
2021 年 5 月检索了 MEDLINE、Embase、Scopus 和 WoS。简要来说，纳入标准包括：1）评估成人 pwMS 中 COVID-19 严重程度的研究；2）明确诊断或高度疑似 COVID-19；3）将 COVID-19 严重程度分类为至少两个类别；4）定量效应大小和精度测量；5）英语语言；6）明确的效应大小/精度测量。使用 NIH 质量评估工具评估研究的内部有效性。根据搜索结果创建了一份可能的风险因素清单，然后用于数据的提取、综合和荟萃分析。
共有 13 项研究纳入综合分析。结果指标要么从论文中提取，要么从主要研究人员那里获得，要么手动计算。荟萃分析显示，除了吸烟和大多数 DMT 外，所有评估的风险因素均显著（P<0.05）增加了 pwMS 发生严重 COVID-19 的几率。
本研究为实践中的基于证据的风险/收益评估提供了便利。接受抗 CD20 治疗的进展性多发性硬化症老年男性更有可能出现不良的 COVID-19 结局。
