Increased rate of hospitalisation for COVID-19 among rituximab-treated multiple sclerosis patients: A study of the Swedish multiple sclerosis registry
Increased rate of hospitalisation for COVID-19 among rituximab-treated multiple sclerosis patients: A study of the Swedish multiple sclerosis registry
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DOI：
10.1177/13524585211026272
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发表时间：
2021-07-02
影响因子：
5.8
通讯作者：
Hillert, Jan
中科院分区：
文献类型：
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作者：
Spelman, Tim;Forsberg, Lars;Hillert, Jan
背景资料：本研究的主要目的是分析多发性硬化症（MS）疾病修饰治疗（DMT）暴露与感染COVID-19患者住院治疗之间的相关性。研究方法：使用单变量和多变量聚类倾向评分加权逻辑回归分析MS DMT暴露与COVID-19住院之间的关联，其中模型对个体患者进行聚类，以控制导致多次COVID-19发作的患者。结果：截至2021年1月18日，瑞典MS登记处共记录了476例MS患者报告的COVID-19病例。其中，292名（61. 3%）已确认COVID-19。感染时的平均年龄（标准差（SD））为44.0岁（11.6岁）。在292例确诊感染中，68例（23.2%）需要住院治疗。在基线时接受利妥昔单抗治疗的164名确诊COVID-19患者中，共有49名（29.9%）需要住院治疗，而所有其他DMT的住院率为12.7%。利妥昔单抗在确诊的COVID-19患者中的住院几率是任何其他DMT组合的2.95倍（比值比= 2.95; 95%置信区间（CI）= 1.48-5.87）。释义：与其他MS DMT相比，已知通常会增加严重感染风险的利妥昔单抗治疗也会为患有COVID-19的MS患者带来这种风险。
Background: The primary objective of this study was to analyse the association between multiple sclerosis (MS) disease-modifying therapy (DMT) exposure and hospitalisation in patients infected with COVID-19. Methods: Associations between MS DMT exposure and COVID-19 hospitalisation were analysed using univariable and multi-variable-clustered propensity score weighted logistic regression, where the models were clustered on the individual patients to control for patients contributing multiple COVID-19 episodes. Findings: As of 18 January 2021, a total of 476 reported COVID-19 cases had been recorded in MS patients in the Swedish MS registry. Of these, 292 (61.3%) had confirmed COVID-19. The mean value (standard deviation (SD)) age at infection was 44.0 years (11.6). Of the 292 confirmed infections, 68 (23.2%) required hospitalisation. A total of 49 of the 164 confirmed COVID-19 patients on rituximab at baseline (29.9%) required hospitalisation, compared to a rate of 12.7% for all other DMTs combined. Rituximab in confirmed COVID-19 patients was associated with 2.95 times the odds of hospitalisation relative to any other DMT combined (odds ratio = 2.95; 95% confidence interval (CI) = 1.48-5.87). Interpretation: Rituximab treatment, known to increase the risk of severe infections in general, also confers such a risk for MS patients with COVID-19, in comparison with other MS DMTs.