Department of Health Sciences, University of Genova, Genoa, Italy.
Centro Sclerosi Multipla ASST Spedali Civili di Brescia, Montichiari, Italy.
Eur J Neurol. 2022 Dec;29(12):3728-3736. doi: 10.1111/ene.15554. Epub 2022 Sep 23.
Clinical outcomes of multiple sclerosis (MS) patients affected by coronavirus disease 2019 (COVID-19) have been thoroughly investigated, but a further analysis on main signs and symptoms and their risk factors still needs attention. The objective of this study was to group together and describe based on similarity the most common signs and symptoms of COVID-19 in MS patients and identify all factors associated with their manifestation.
Logistic and linear regression models were run to recognize factors associated with each pooled group of symptoms and their total number.
From March 2020 to November 2021, data were collected from 1354 MS patients with confirmed infection of COVID-19. Ageusia and anosmia was less frequent in older people (odds ratio [OR] 0.98; p = 0.005) and more in smoker patients (OR 1.39; p = 0.049). Smoke was also associated with an incremental number of symptoms (OR 1.24; p = 0.031), substance abuse (drugs or alcohol), conjunctivitis and rash (OR 5.20; p = 0.042) and the presence of at least one comorbidity with shortness of breath, tachycardia or chest pain (OR 1.24; p = 0.008). Some disease-modifying therapies were associated with greater frequencies of certain COVID-19 symptoms (association between anti-CD20 therapies and increment in the number of concomitant symptoms: OR 1.29; p = 0.05). Differences in frequencies between the three waves were found for flu-like symptoms (G1, p = 0.024), joint or muscle pain (G2, p = 0.013) and ageusia and anosmia (G5, p < 0.001). All cases should be referred to variants up to Delta.
Several factors along with the choice of specific therapeutic approaches might have a different impact on the occurrence of some COVID-19 symptoms.
已对受 2019 年冠状病毒病（COVID-19）影响的多发性硬化症（MS）患者的临床结局进行了全面研究，但仍需要进一步分析主要症状及其危险因素。本研究的目的是将 MS 患者 COVID-19 最常见的症状分组并基于相似性进行描述，并确定与表现相关的所有因素。
使用逻辑回归和线性回归模型来识别与每组症状及其总数相关的因素。
2020 年 3 月至 2021 年 11 月，从 1354 例确诊 COVID-19 感染的 MS 患者中收集数据。味觉丧失和嗅觉丧失在老年人中较少见（比值比[OR]0.98；p=0.005），而在吸烟者中更为常见（OR 1.39；p=0.049）。吸烟也与症状数量增加相关（OR 1.24；p=0.031）、物质滥用（药物或酒精）、结膜炎和皮疹（OR 5.20；p=0.042）以及至少有一种伴有呼吸急促、心动过速或胸痛的合并症（OR 1.24；p=0.008）。一些疾病修正治疗与 COVID-19 某些症状的更高频率相关（抗 CD20 治疗与同时发生症状数量增加之间的关联：OR 1.29；p=0.05）。在流感样症状（G1，p=0.024）、关节或肌肉疼痛（G2，p=0.013）和味觉丧失和嗅觉丧失（G5，p<0.001）方面，发现了三个波之间的频率差异。所有病例均应报告至 Delta 变体。
多种因素以及特定治疗方法的选择可能对某些 COVID-19 症状的发生产生不同的影响。
