Factors associated with COVID-19 susceptibility and severity in patients with multiple sclerosis: A systematic review

Abstract

Background: We conducted this systematic review to identify factors associated with coronavirus disease (COVID-19) susceptibility and outcomes among people with multiple sclerosis (MS). Methods: Available studies from PubMed, Scopus, EMBASE, Web of Science, and gray literature including reference list and conference abstracts were searched from December 1, 2019, through April 12, 2021. We included cross-sectional, case-control, and cohort studies that reported risk factors of contracting COVID-19 or its outcome in patients with MS on univariate or multivariate regression analyses. Results: Out of the initial 2719 records and 1553 conference abstracts, a total of 20 studies were included. Factors associated with COVID-19 susceptibility were reported in 11 studies and risk factors for infection outcomes were discussed in 10. History of contact with an infected is strongly suggested as a risk factor for COVID-19 susceptibility. Other factors that could be associated with contracting infection are younger age, relapsing course, and anti-CD20 agents. The evidence suggests that increasing age, greater MS severity, treatment with anti-CD20 agents, previous use of corticosteroids, and specific comorbidities (obesity and coronary artery disease) could be independently associated with worse infection outcomes. Male sex is likely to be a risk factor for more severe disease. The black or African American race was reported as a possible risk factor. Conclusion: Due to a paucity of research and methodological issues, no risk factors for COVID-19 susceptibility and outcomes neither be confirmed nor excluded. Further large studies are needed to address factors associated with COVID-19 susceptibility and severity.

Unraveling the Mystery of COVID-19 Postvaccination Myocarditis: A Systematic Review of Current Cases

“…Nonetheless, it could be deduced that the data released on the elderly might have had some sort of bias, especially in favor of underreporting. In other words, milder forms of myocarditis in elder patients would have easily been overlooked by their possible underlying cardiac diseases [ 21 , 22 ].…”

Association of Disease-Modifying Therapies with COVID-19 Susceptibility and Severity in Patients with Multiple Sclerosis: A Systematic Review and Network Meta-Analysis

“…The outbreak of Coronavirus Disease-2019 (COVID- 19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a newly emerging pandemic. This globally spreading virus affects people in different ways, with manifestations ranging from no symptoms to hospitalization and death due to acute respiratory distress syndrome (ARDS) [1,2]. More than one year after the outbreak of COVID-19, the number of reported COVID-19 cases exceeds 150 million, with more than 3.5 million deaths [3].…”

“…This raised a question regarding whether people living with MS were at higher risk of COVID-19 and were more likely to develop severe symptoms when infected than the general population. A recent systematic review has suggested a mortality rate of 3.5% among MS patients considering suspected/confirmed COVID-19 cases, which is slightly higher than the rate of 2.2% among the general population [ 2 , 7 ]. This study showed that patients on anti-CD20 agents had highest rates of hospitalization and mortality than those on other DMTs.…”