Disease-Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis.
Disease-Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis.
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DOI：
10.1002/ana.26028
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发表时间：
2021-04
影响因子：
11.2
通讯作者：
Musc-19 Study Group
中科院分区：
文献类型：
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作者：
Sormani MP;De Rossi N;Schiavetti I;Carmisciano L;Cordioli C;Moiola L;Radaelli M;Immovilli P;Capobianco M;Trojano M;Zaratin P;Tedeschi G;Comi G;Battaglia MA;Patti F;Salvetti M;Musc-19 Study Group
本研究旨在评估免疫抑制和免疫调节疗法对多发性硬化症（PwMS）患者2019冠状病毒病（COVID - 19）严重程度的影响。我们回顾性收集了疑似或确诊COVID - 19的PwMS数据。所有患者均随访至死亡或康复。重症COVID - 19由一个3级变量定义：轻度疾病不需要住院治疗vs肺炎，住院治疗vs重症监护病房（ICU）入院或死亡。我们通过多变量和倾向评分（PS）加权有序逻辑模型评估了与重症COVID - 19相关的基线特征和MS治疗。进行敏感性分析以证实结果。在844例疑似（n = 565）或确诊（n = 279） COVID - 19的PwMS中，13例（1.54%）死亡；其中11例处于MS进展期，8例未接受任何治疗。38例（4.5%）入住ICU；99例（11.7%）有影像学证实的肺炎；96例（11.4%）住院。在调整了地区、年龄、性别、进展性MS病程、扩展残疾状态量表、病程、体重指数、合共病和近期使用甲基强龙后，抗CD20药物（ocrelizumab或rituximab）治疗与严重COVID - 19风险增加显著相关（优势比[or] = 2.37, 95%可信区间[CI] = 1.18-4.74, p = 0.015）。近期使用甲基强的松龙（<1个月）也与较差的预后相关（OR = 5.24, 95% CI = 2.20-12.53, p = 0.001）。结果通过PS加权分析和所有敏感性分析得到证实。这项研究表明，具有广泛作用机制的治疗方法具有可接受的安全水平。然而，出现了一些具体的风险因素。在COVID - 19大流行持续期间，需要考虑这些问题。Ann neurol 2021；89:780 - 789
This study was undertaken to assess the impact of immunosuppressive and immunomodulatory therapies on the severity of coronavirus disease 2019 (COVID‐19) in people with multiple sclerosis (PwMS). We retrospectively collected data of PwMS with suspected or confirmed COVID‐19. All the patients had complete follow‐up to death or recovery. Severe COVID‐19 was defined by a 3‐level variable: mild disease not requiring hospitalization versus pneumonia or hospitalization versus intensive care unit (ICU) admission or death. We evaluated baseline characteristics and MS therapies associated with severe COVID‐19 by multivariate and propensity score (PS)‐weighted ordinal logistic models. Sensitivity analyses were run to confirm the results. Of 844 PwMS with suspected (n = 565) or confirmed (n = 279) COVID‐19, 13 (1.54%) died; 11 of them were in a progressive MS phase, and 8 were without any therapy. Thirty‐eight (4.5%) were admitted to an ICU; 99 (11.7%) had radiologically documented pneumonia; 96 (11.4%) were hospitalized. After adjusting for region, age, sex, progressive MS course, Expanded Disability Status Scale, disease duration, body mass index, comorbidities, and recent methylprednisolone use, therapy with an anti‐CD20 agent (ocrelizumab or rituximab) was significantly associated (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.18–4.74, p = 0.015) with increased risk of severe COVID‐19. Recent use (<1 month) of methylprednisolone was also associated with a worse outcome (OR = 5.24, 95% CI = 2.20–12.53, p = 0.001). Results were confirmed by the PS‐weighted analysis and by all the sensitivity analyses. This study showed an acceptable level of safety of therapies with a broad array of mechanisms of action. However, some specific elements of risk emerged. These will need to be considered while the COVID‐19 pandemic persists. ANN NEUROL 2021;89:780–789
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DOI：
10.1126/science.abd4585
发表时间：
2020-10-23
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Bastard P;Rosen LB;Zhang Q;Michailidis E;Hoffmann HH;Zhang Y;Dorgham K;Philippot Q;Rosain J;Béziat V;Manry J;Shaw E;Haljasmägi L;Peterson P;Lorenzo L;Bizien L;Trouillet-Assant S;Dobbs K;de Jesus AA;Belot A;Kallaste A;Catherinot E;Tandjaoui-Lambiotte Y;Le Pen J;Kerner G;Bigio B;Seeleuthner Y;Yang R;Bolze A;Spaan AN;Delmonte OM;Abers MS;Aiuti A;Casari G;Lampasona V;Piemonti L;Ciceri F;Bilguvar K;Lifton RP;Vasse M;Smadja DM;Migaud M;Hadjadj J;Terrier B;Duffy D;Quintana-Murci L;van de Beek D;Roussel L;Vinh DC;Tangye SG;Haerynck F;Dalmau D;Martinez-Picado J;Brodin P;Nussenzweig MC;Boisson-Dupuis S;Rodríguez-Gallego C;Vogt G;Mogensen TH;Oler AJ;Gu J;Burbelo PD;Cohen JI;Biondi A;Bettini LR;D'Angio M;Bonfanti P;Rossignol P;Mayaux J;Rieux-Laucat F;Husebye ES;Fusco F;Ursini MV;Imberti L;Sottini A;Paghera S;Quiros-Roldan E;Rossi C;Castagnoli R;Montagna D;Licari A;Marseglia GL;Duval X;Ghosn J;HGID Lab;NIAID-USUHS Immune Response to COVID Group;COVID Clinicians;COVID-STORM Clinicians;Imagine COVID Group;French COVID Cohort Study Group;Milieu Intérieur Consortium;CoV-Contact Cohort;Amsterdam UMC Covid-19 Biobank;COVID Human Genetic Effort;Tsang JS;Goldbach-Mansky R;Kisand K;Lionakis MS;Puel A;Zhang SY;Holland SM;Gorochov G;Jouanguy E;Rice CM;Cobat A;Notarangelo LD;Abel L;Su HC;Casanova JL
通讯作者：
Casanova JL
影响因子：
5.9
作者：
Ren L;Zhang L;Chang D;Wang J;Hu Y;Chen H;Guo L;Wu C;Wang C;Wang Y;Wang Y;Wang G;Yang S;Dela Cruz CS;Sharma L;Wang L;Zhang D;Wang J
通讯作者：
Wang J
影响因子：
158.5
作者：
Hauser, S. L.;Bar-Or, A.;Kappos, L.
通讯作者：
Kappos, L.
影响因子：
5.8
作者：
Peeters, Liesbet M.;Parciak, Tina;Rijke, Nick
通讯作者：
Rijke, Nick
影响因子：
6
作者：
Schweitzer F;Laurent S;Fink GR;Barnett MH;Hartung HP;Warnke C
通讯作者：
Warnke C