Neuroscience Institute, Multiple sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Managment of Statistic and Information Technology, Ministry of Health and Medical Education, Tehran, Iran.
Mult Scler Relat Disord. 2022 Nov;67:104067. doi: 10.1016/j.msard.2022.104067. Epub 2022 Jul 22.
This study aimed to consider the main risk factors related to adverse clinical outcomes in MS patients with COVID-19.
Using the electronic health records systems, this is a cross-sectional study of two years of hospital admissions in terms of COVID-19 in Iran from March 2019 to August 2021. The severities of COVID-19 outcomes were admitted to ICU, hospitalization days, and in-hospital mortality.
A total of 1634 hospitalized MS patients with a definite diagnosis of COVID-19 based on PCR were recorded in the electronic health systems. MS patients had a 7% increased risk for longer hospitalization, a 3% increased risk for the need to the ICU, and no increased risk of mortality compared with the general population. MS patients who were taking immunosuppressive (IS)-disease modifying therapies (DMT) had longer hospitalization (adjusted OR=2.06, 95%CI: 1.48, 2.86) and higher mortality risk (adjusted OR=2.05, 95%CI: 1.52, 6.29) compared to patients were under the immunomodulatory (IM)-DMT. There was not any significant association between the types of DMT and ICU (12.2% vs. 12.7%). Besides, MS patients who were vaccinated against COVID-19 before admission had shorter hospitalization (adjusted OR=0.40, 95% CI: 0.18, 0.92).
The current data suggest that MS healthcare providers should consider specific risks of severe COVID-19 infection before starting IS-DMT.
本研究旨在考虑与 COVID-19 合并 MS 患者不良临床结局相关的主要风险因素。
本研究为横断面研究，通过电子病历系统回顾了 2019 年 3 月至 2021 年 8 月期间伊朗两年内因 COVID-19 住院的病例。COVID-19 结局严重程度包括入住 ICU、住院天数和院内死亡率。
共记录了 1634 例基于 PCR 确诊为 COVID-19 的住院 MS 患者。与普通人群相比，MS 患者住院时间延长的风险增加了 7%，入住 ICU 的风险增加了 3%，但死亡率没有增加。与接受免疫调节（IM）-疾病修正治疗（DMT）的 MS 患者相比，接受免疫抑制（IS）-DMT 的 MS 患者住院时间更长（校正 OR=2.06，95%CI：1.48，2.86），死亡率更高（校正 OR=2.05，95%CI：1.52，6.29）。DMT 类型与 ICU 之间无显著相关性（12.2%比 12.7%）。此外，入院前接种 COVID-19 疫苗的 MS 患者住院时间更短（校正 OR=0.40，95%CI：0.18，0.92）。
目前的数据表明，MS 医疗保健提供者在开始 IS-DMT 之前应考虑 COVID-19 感染的严重风险。
