Outcomes of COVID-19 infection in multiple sclerosis and related conditions: One-year pandemic experience of the multicenter New York COVID-19 Neuroimmunology Consortium (NYCNIC)

Abstract

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

“…Five studies with 36912 MS patients consisting of 616 cases of suspected/confirmed COVID-19 investigated association of DMTs with COVID-19 susceptibility [ 9 , 13 – 16 ]. Five studies, including 3639 MS patients with COVID-19, evaluated association of DMTs with COVID-19 severity [ 17 – 21 ]. Two of the included studies were cross-sectional [ 13 , 17 ], 7 were cohort [ 9 , 14 – 16 , 18 – 21 ], and one was pharmacovigilance [ 9 ].…”

“…Five studies, including 3639 MS patients with COVID-19, evaluated association of DMTs with COVID-19 severity [ 17 – 21 ]. Two of the included studies were cross-sectional [ 13 , 17 ], 7 were cohort [ 9 , 14 – 16 , 18 – 21 ], and one was pharmacovigilance [ 9 ]. Four studies reported data from the USA [ 9 , 16 , 17 , 21 ], two from Spain [ 15 , 20 ], and one from each of Italy, [ 18 ] Iran, [ 13 ] and Sweden [ 19 ].…”

“…We performed no publication bias test since less than 10 studies were 7 Multiple Sclerosis International pharmacovigilance [9]. Four studies reported data from the USA [9,16,17,21], two from Spain [15,20], and one from each of Italy, [18] Iran, [13] and Sweden [19]. One study was multicentric from Europe [14].…”

“…The network graphs and forest plots for the association of DMTs with COVID-19 severity are presented in Figures 2 and 4. Based on univariate analysis, two studies assessing the association of DMTs with COVID-19 severity were included in the NMA [20,21]. In 9 Multiple Sclerosis International the comparison of DMTs with no DMT, natalizumab was associated with a decreased risk of severe infection (OR = 0:28, 95% CI: 0.10, 0.81; P score = 0.08) (Figure 4(a)).…”

Multiple sclerosis and the risk of infection: Association of British Neurologists consensus guideline

“…The risk of severe COVID-19 in people with MS is increased by use of certain immunomodulating therapies,5 7 153–155 as well as by the presence of factors associated with an increased risk in the general population, such as increasing age, male sex, comorbidities, and having Black/African, Asian or minority ethnic ancestry 153 154 156–164. MS with a progressive disease course and increased levels of disability is also associated with more severe COVID-19 infection 153–158 160 161 163 165. Several studies have found associations between exposure to anti-CD20 DMTs and COVID-19 frequency and/or COVID-19 severity 153 154 159–161 166 167.…”