美国7620例因新冠肺炎住院的多发性硬化症患者的特征与结局

Characteristics and Outcomes of 7620 Multiple Sclerosis Patients Admitted With COVID-19 in the United States.

作者信息

Ramphul Kamleshun, Sombans Shaheen, Verma Renuka, Lohana Petras, Dhillon Balkiranjit Kaur, Gonzalez Mejias Stephanie, Sanikommu Sailaja, Ramphul Yogeshwaree, Pekyi-Boateng Prince Kwabla

机构信息

Independent Researcher, Triolet, Mauritius.

Department of Neurology, Bharati Vidyapeeth University Medical College and Hospital, Hyderabad, India.

出版信息

Neurohospitalist. 2024 Jul;14(3):237-241. doi: 10.1177/19418744241230728. Epub 2024 Jan 27.

Abstract

BACKGROUND

At the start of the COVID-19 pandemic, several experts raised concerns about its impact on Multiple Sclerosis (MS) patients. This study aims to provide a perspective using the biggest inpatient database from the United States.

METHOD

We screened for COVID-19 cases between April to December 2020, via the 2020 National Inpatient Sample (NIS). Various outcomes were analyzed.

RESULTS

We identified 1,628,110 hospitalizations with COVID-19, including 7620 (.5%) MS patients. 8.9% of MS patients with COVID-19 died, and it was lower than non-MS cases (12.9%). Less MS patients with COVID-19 needed non-invasive ventilation (4.5% vs 6.4%) and mechanical ventilation (9.0% vs 11.2%). Furthermore, MS patients with COVID-19 reported higher odds of non-invasive ventilation if they were ≥60 years, had chronic pulmonary disease (CPD), obesity, or diabetes. Private insurance beneficiaries showed reduced risk, vs Medicare. Similarly, for mechanical ventilation, those ≥60 years, with alcohol abuse, obesity, diabetes, hypertension, or dialysis had higher odds, while females, smokers, and those with depression or hyperlipidemia showed reduced odds. The study revealed higher odds of mortality among those aged ≥60, who had CPD, obesity, CKD, or a history of old MI while females, smokers, as well as those with depression, and hyperlipidemia showed better outcomes. Blacks had lower odds, whereas Hispanics had higher odds of death, vs Whites. Medicaid and Privately insured patients had lower odds of dying vs Medicare.

CONCLUSION

We found several differences in patient characteristics and outcomes among MS and non-MS patients with COVID-19.

摘要

背景

在新冠疫情开始时,几位专家对其对多发性硬化症(MS)患者的影响表示担忧。本研究旨在利用美国最大的住院患者数据库提供一种观点。

方法

我们通过2020年全国住院患者样本(NIS)筛查了2020年4月至12月期间的新冠病例。分析了各种结果。

结果

我们确定了1,628,110例新冠住院病例,其中包括7620例(0.5%)MS患者。感染新冠的MS患者中有8.9%死亡,低于非MS病例(12.9%)。感染新冠的MS患者需要无创通气(4.5%对6.4%)和机械通气(9.0%对11.2%)的比例较低。此外,感染新冠的MS患者如果年龄≥6岁且患有慢性肺病(CPD)、肥胖症或糖尿病,则无创通气的几率更高。与医疗保险相比,私人保险受益人的风险降低。同样,对于机械通气,年龄≥60岁、有酗酒、肥胖、糖尿病、高血压或透析史的患者几率更高,而女性、吸烟者以及患有抑郁症或高脂血症的患者几率降低。研究显示,年龄≥60岁、患有CPD、肥胖症、慢性肾病(CKD)或有陈旧性心肌梗死病史的患者死亡率较高,而女性、吸烟者以及患有抑郁症和高脂血症的患者预后较好。与白人相比,黑人死亡几率较低,而西班牙裔死亡几率较高。与医疗保险相比,医疗补助和私人保险患者死亡几率较低。

结论

我们发现感染新冠的MS患者和非MS患者在患者特征和结果方面存在一些差异。

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