Prognostic indicators for hospitalization and ICU admission in people with multiple sclerosis and COVID-19: an analysis of the COVID-19 in MS global data sharing initiative dataset

Maria A Garcia-Dominguez; Vincent Kipkorir; Bahadar S Srichawla

doi:10.1097/MS9.0000000000001676

Prognostic indicators for hospitalization and ICU admission in people with multiple sclerosis and COVID-19: an analysis of the COVID-19 in MS global data sharing initiative dataset

Ann Med Surg (Lond). 2024 Jan 3;86(2):720-725. doi: 10.1097/MS9.0000000000001676. eCollection 2024 Feb.

Authors

Maria A Garcia-Dominguez¹, Vincent Kipkorir², Bahadar S Srichawla¹

Affiliations

¹ Department of Neurology, University of Massachusetts Chan Medical School, MA, USA.
² Department of Medicine, University of Nairobi, Nairobi, Kenya.

Abstract

Objectives: To analyze the symptoms and severity of coronavirus disease 2019 (COVID-19) in people with multiple sclerosis (pwMS) on disease-modifying therapies using data from the COVID-19 in multiple sclerosis (MS) Global Data Sharing Initiative dataset.

Methods: The open-access COVID-19 in MS Global Data Sharing Initiative dataset was obtained through credentialed access using PhysioNet. The variables analyzed included BMI, symptoms of COVID-19, age, current use of disease-modifying therapy (DMT), efficacy of DMT, comorbidities, hospitalization status, and type of MS. A linear regression analysis was completed. Data analysis and visualization were completed using STATA v15, R-Studio v1.1.447, Python v3.8, and its associated libraries, including NumPy, Pandas, and Matplotlib.

Results: A total of 1141 participants were included in the analysis. 904 women and 237 men were diagnosed with MS. Among the pwMS included in the study; 208 (19.54%) had a suspected infection with COVID-19 and only 49 (5.25%) were confirmed. Any COVID-19 symptom was present in 360 individuals. The commonly reported DMT agents included dimethyl fumarate (12.71%) and fingolimod (10.17%). 101 in total (8.85%) reported not using any DMT. Factors associated with hospitalization and/or admission to the ICU included having any comorbidity (P=0.01), neuromuscular disorder (P=0.046), hypertension (P=0.005), chronic kidney disease (P<0.001), and immunodeficiency (P=0.003). The type of MS, the duration of the disease, and high-efficacy DMT therapy did not have a statistically significant influence on hospitalization.

Conclusion: This study underscores the importance of comorbidities, especially neuromuscular disorders, hypertension, chronic kidney disease, and immunodeficiencies, as possible prognostic indicators for worse outcomes of COVID-19 in pwMS. On the contrary, the type of MS, the duration of the disease, and the efficacy of disease-modifying therapy did not significantly affect the severity of the symptoms of COVID-19 in this cohort.

Keywords: COVID-19; SARS-CoV-2; disease-modifying therapy; hospitalization; intensive care unit; multiple sclerosis; people with multiple sclerosis.