The impact of COVID-19 infection on multiple sclerosis disease course across 12 countries : a propensity-score-matched cohort study
Levitz, David (Central Clinical School. Monash University. Department of Neuroscience (Austràlia))
Chao Foong, Yi (The Alfred Hospital (Austràlia))
Sanfilippo, Paul (Central Clinical School. Monash University (Austràlia))
Spelman, Tim (Karolinska Institute (Suècia))
Rath, Louisse (Central Clinical School. Monash University (Austràlia))
Roldan, Angie (Central Clinical School. Monash University (Austràlia))
Lal, Anoushka (Central Clinical School. Monash University (Austràlia))
Monif, Mastura (Central Clinical School. Monash University (Austràlia))
Jokubaitis, V. (Central Clinical School. Monash University (Austràlia))
Ozakbas, Serkan (Dokuz Eylul University (Turquia))
Alroughani, Raed (Amiri Hospital (Kuwait))
Boz, Cavit (KTU Medical Faculty Farabi Hospital (Turquia))
Terzi, Murat (19 Mayis University (Turquia))
Kalincik, Tomas (CORe. Department of Medicine. University of Melbourne (Austràlia))
Blanco Morgado, Yolanda (Hospital Clínic i Provincial de Barcelona)
Foschi, Matteo (University of L'Aquila)
Surcinelli, Andrea (S. Maria delle Croci Hospital of Ravenna. AUSL Romagna (Itàlia))
Buzzard, Katherine (Eastern Health Clinical School. Monash University (Austràlia))
Skibina, Olga (Eastern Health Clinical School. Monash University (Austràlia))
Laureys, Guy (University Hospital Ghent (Bèlgica))
Van Hijfte, Liesbeth (University Hospital Ghent (Bèlgica))
Ramo-Tello, Cristina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Soysal, Aysun (Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases (Istanbul, Turquia))
Sánchez Menoyo, José Luis (Hospital de Galdakao (Usansolo, Biscaia))
Habek, Mario (School of Medicine. University of Zagreb (Croàcia))
Cartechini, Elisabetta (Azienda Sanitaria Unica Regionale Marche (Itàlia))
Rojas, Juan Ignacio (Hospital Universitario de CEMIC (Argentina))
Karabudak, Rana (Hacettepe University (Turquia))
Willekens, Barbara (University of Antwerp (Bèlgica))
Al-Harbi, Talal (King Fahad Specialist Hospital-Dammam (Àrabia Saudita))
Fragoso, Yara (Universidade Metropolitana de Santos (Brasil))
Castillo-Triviño, Tamara (Hospital Universitario Donostia and IIS Biodonostia)
Decoo, Danny (AZ Alma Ziekenhuis (Bèlgica))
Aragon de Vecino, Maria Cecilia (Hospital Moinhos de Vento (Brasil))
Skromne, Eli (Hospital Angeles de las Loma (Mèxic))
Sirbu, Carmen-Adella (Titu Maiorescu University (Romania))
Zhu, Chao (Monash University)
Merlo, Daniel (Box Hill Hospital (Victòria, Austràlia))
Gresle, Melissa (Central Clinical School. Monash University (Austràlia))
Butzkueven, Helmut (The Alfred Hospital (Austràlia))
van der Walt, Anneke (Central Clinical School. Monash University (Austràlia))

Data:	2024
Resum:	Background: The relationship between coronavirus disease 2019 (COVID-19) infection and multiple sclerosis (MS) relapse and disease progression remains unclear. Previous studies are limited by small sample sizes and most lack a propensity-matched control cohort. Objective: To evaluate the effect of COVID-19 infection on MS disease course with a large propensity-matched cohort. Design: This multi-centre cohort study analysed relapse and disability outcomes post-COVID-19 infection after balancing covariates using a propensity score matching method. The study period was from the 11th of September 2019 to the 16th of February 2023. The mean follow-up period was 1. 7 years. Methods: Data were retrieved from the MSBase Registry. Propensity scores were obtained based on age, sex, disease duration, baseline Expanded Disability Status Scale (EDSS), MS course, relapses pre-baseline, disease-modifying therapy (DMT) class and country. Primary outcomes were time to first relapse, annualised relapse rate (ARR) and time to confirm EDSS progression. Secondary outcomes were time to EDSS of 3, 4 or 6. Sensitivity analyses with baseline DMT classes were performed. Results: The study included 2253 cases and 6441 controls. After matching, there were 2161 cases and an equal number of matched controls. Cases had a significantly higher ARR (ARR = 0. 10 [95% CI 0. 09-0. 11]) compared to controls (ARR = 0. 07 [95% CI 0. 06-0. 08]). Cases had a significantly greater hazard of time to first relapse compared to controls (hazard ratio (HR) = 1. 54 [95% CI 1. 29-1. 84]). There was no association between COVID-19 infection and 24-week EDSS progression (HR = 1. 18 [95% CI 0. 92-1. 52]), or time to EDSS of 3, 4 or 6. For patients on interferons and glatiramer acetate (BRACE), COVID-19 infection was associated with a greater hazard of time to first relapse (HR = 1. 83 [95% CI 1. 25-2. 68]) and greater hazard of time to EDSS of 3 (HR = 2. 04 [95% CI 1. 06-3. 90]) compared to patients on BRACE therapy without COVID-19 infection. Conclusion: COVID-19 infection was associated with a significantly increased MS relapse rate and a shorter time to first relapse. There was no effect on confirmed EDSS progression over the short term. These results support ongoing COVID-19 risk minimisation strategies to protect patients with MS.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COVID-19 ; Disease progression ; Multiple sclerosis ; Relapse
Publicat a:	Therapeutic Advances in Neurological Disorders, Vol. 17 (November 2024) , ISSN 1756-2864

DOI: 10.1177/17562864241278496
PMID: 39525878

16 p, 1.4 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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