Severe outcomes of COVID-19 among patients with multiple sclerosis under anti-CD-20 therapies: A systematic review and meta-analysis.
Severe outcomes of COVID-19 among patients with multiple sclerosis under anti-CD-20 therapies: A systematic review and meta-analysis.
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DOI：
10.1016/j.msard.2021.103358
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发表时间：
2022-01
影响因子：
4
通讯作者：
Sormani MP
中科院分区：
文献类型：
--
作者：
Schiavetti I;Ponzano M;Signori A;Bovis F;Carmisciano L;Sormani MP
COVID-19可能通过各种方式传播，从无症状到严重形式，直到呼吸衰竭，危急情况和死亡发生。对于受多发性硬化症影响的患者，特别是那些正在接受疾病改善治疗的患者，特别值得关注。一些研究发现抗CD 20疗法（尤其是利妥昔单抗）与严重的COVID-19之间存在关联。然而，结果并不总是明确的，因此系统的审查是有帮助的。由两位作者在主要检索工具上独立进行了系统性文献检索，将ocrelizumab或利妥昔单抗治疗后COVID-19阳性患者的数据作为关键入选标准。根据MOOSE提出的荷兰科克伦中心批判性审查清单的修改版本评价纳入研究的质量，如果数据缺失，则向相应作者发送电子邮件，要求提供缺失信息。排除病例报告后，使用连续性校正进行比例的随机效应荟萃分析，并计算I2统计量以衡量异质性。29篇文章被纳入分析，在整合了作者提供的额外详细信息后，文章的中位质量达到4/5。这些文章包括5173例患者，其中分别有770例（14.8%）和455例（8.8%）接受ocrelizumab和利妥昔单抗治疗。ocrelizumab和利妥昔单抗治疗患者的住院、肺炎和重症监护病房入院的汇总估计值分别为18.1%、14.8%和3.3%，而死亡的汇总估计值分别为1.8%和1.6%和4.5%。与接受其他治疗的患者相比，接受利妥昔单抗治疗的患者发生严重COVID-19结局的风险似乎更高。
COVID-19 may spread through various ways ranging from asymptomatic to severe forms, until respiratory failure, critical conditions and death occurs. There is a particular concern for patients affected by multiple sclerosis, especially for those under disease-modifying treatments. Some studies have found an association between anti-CD20 therapies (especially rituximab) and severe COVID-19. However, results were not always clear and thus a systematic review was helpful. A systematic literature search was performed independently by two authors on the main search tools considering as key inclusion criterion the presence of data on patients under ocrelizumab or rituximab positive to COVID-19. The quality of the included studies was evaluated based on a modified version of the Dutch Cochrane center critical review checklist proposed by MOOSE and in case of missing data an email was sent to the corresponding authors asking for missing information. After excluding case-reports, a random effects meta-analysis of proportions was conducted using the continuity correction and the I2statistic was calculated to measure heterogeneity. 29 articles were included in the analysis and the median quality of the articles reached 4/5 after having integrated the additional details provided by the authors. The articles included 5173 patients, of whom 770 (14.8%) and 455 (8.8%) were, respectively, under ocrelizumab and rituximab. Pooled estimates of hospitalization, pneumonia and intensive care unit admission were 18.1%, 14.8% and 3.3%, respectively, while pooled estimate for death was 1.8% overall and 1.6% and 4.5%, respectively, for patients under ocrelizumab and rituximab. Patients treated with rituximab seem to be at higher risk of severe COVID-19 outcomes compared to patients under other treatments.
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DOI：
10.15585/mmwr.mm6915e3
发表时间：
2020-04-17
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Garg S;Kim L;Whitaker M;O'Halloran A;Cummings C;Holstein R;Prill M;Chai SJ;Kirley PD;Alden NB;Kawasaki B;Yousey-Hindes K;Niccolai L;Anderson EJ;Openo KP;Weigel A;Monroe ML;Ryan P;Henderson J;Kim S;Como-Sabetti K;Lynfield R;Sosin D;Torres S;Muse A;Bennett NM;Billing L;Sutton M;West N;Schaffner W;Talbot HK;Aquino C;George A;Budd A;Brammer L;Langley G;Hall AJ;Fry A
通讯作者：
Fry A
多发性硬化症中的Covid-19的严重程度和死亡率与免疫疗法无关：来自全国性奥地利注册中心的见解。
影响因子：
3.7
作者：
Bsteh G;Assar H;Hegen H;Heschl B;Leutmezer F;Di Pauli F;Gradl C;Traxler G;Zulehner G;Rommer P;Wipfler P;Guger M;Enzinger C;Berger T;AUT-MuSC investigators
通讯作者：
AUT-MuSC investigators
影响因子：
5.3
作者：
Fernandez-Diaz E;Perez-Vicente JA;Villaverde-Gonzalez R;Berenguer-Ruiz L;Candeliere Merlicco A;Martinez-Navarro ML;Gracia Gil J;Romero-Sanchez CM;Alfaro-Saez A;Diaz I;Gimenez-Martinez J;Mendez-Miralles MA;Millan-Pascual J;Jimenez-Pancho J;Mola S;Sempere AP
通讯作者：
Sempere AP
影响因子：
5.8
作者：
Loonstra, Floor C.;Hoitsma, Elske;Mostert, Jop P.
通讯作者：
Mostert, Jop P.
影响因子：
5.8
作者：
Spelman, Tim;Forsberg, Lars;Hillert, Jan
通讯作者：
Hillert, Jan