COVID-19 in multiple sclerosis patients: susceptibility, severity risk factors and serological response
COVID-19 in multiple sclerosis patients: susceptibility, severity risk factors and serological response
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DOI：
10.1111/ene.14690
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发表时间：
2021-01-09
影响因子：
5.1
通讯作者：
Montalban, Xavier
中科院分区：
文献类型：
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作者：
Zabalza, Ana;Cardenas-Robledo, Simon;Montalban, Xavier
背景和目的：关于2019年新型冠状病毒病（COVID-19）多发性硬化（MS）患者的信息很少。研究目的是描述MS患者COVID-19的发病率和特征，确定易感性和严重程度风险因素，并根据疾病缓解治疗评估严重急性呼吸综合征冠状病毒2（SARS-CoV-2）血清学阳性的比例。方法：这是一项回顾性研究，分析2020年2月至5月期间收集的MS队列数据。通过电子邮件调查和临床访视确定病例。研究了人口统计学和MS特征与COVID-19的关系以及疾病修饰治疗与SARS-CoV-2血清状态的关系。结果：收集了758名有效受访者中48名疑似病例和45名通过临床访视确定的COVID-19病例的数据。发病率为6.3%。19例（20.3%）患者住院治疗，2例（2.2%）患者死亡。多变量模型确定了年龄（每10年的比值比[OR] 0.53，95%置信区间[CI] 0.34-0.85），与确诊病例接触（OR 197.02，95% CI 56.36-688.79），居住在巴塞罗那（OR 2.23，95% CI 1.03-4.80），MS持续时间（OR每5年1.41，95% CI 1.09-1.83）和抗CD 20治疗时间（OR每2年3. 48，95% CI 1. 44 - 8. 45）是呈现COVID-19的独立因素，而年龄（OR每10年2. 71，95% CI 1. 13 - 6. 53）是严重COVID-19的独立因素。在79例（84.9%）血清学检测中，45.6%产生抗体，但只有17.6%的抗CD 20治疗。结论：多发性硬化症患者与普通人群相比，COVID-19的发病率、危险因素和结局相似。接受抗CD 20治疗较长时间的患者可能面临更高的COVID-19风险，并且不到20%的患者产生抗体应答。只有年龄与严重程度相关。
Background and purpose: Information regarding multiple sclerosis (MS) patients with the 2019 novel coronavirus disease (COVID-19) is scarce. The study objective was to describe the incidence and characteristics of MS patients with COVID-19, to identify susceptibility and severity risk factors and to assess the proportion of positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serologies according to disease-modifying treatments.Methods: This was a retrospective study of an MS cohort analysing data collected between February and May 2020. Cases were identified through an email survey and clinical visits. The relationship of demographic and MS characteristics with COVID-19 and of the disease-modifying treatments with SARS-CoV-2 serostatus were examined.Results: Data from 48 suspected cases out of 758 valid respondents and from 45 COVID-19 cases identified through clinical visits were collected. Incidence was 6.3%. Nineteen (20.3%) patients were hospitalized and two (2.2%) died. Multivariable models determined that age (odds ratio [OR] per 10 years 0.53, 95% confidence interval [CI] 0.34-0.85), contact with a confirmed case (OR 197.02, 95% CI 56.36-688.79), residence in Barcelona (OR 2.23, 95% CI 1.03-4.80), MS duration (OR per 5 years 1.41, 95% CI 1.09-1.83) and time on anti-CD20 treatment (OR per 2 years 3.48, 95% CI 1.44-8.45) were independent factors for presenting COVID-19 and age (OR per 10 years 2.71, 95% CI 1.13-6.53) for a severe COVID-19. Out of the 79 (84.9%) with serological test, 45.6% generated antibodies, but only 17.6% of those on anti-CD20 therapies. Lymphopaenia or immunoglobulin levels did not relate to COVID-19.Conclusions: Multiple sclerosis patients present similar incidence, risk factors and outcomes for COVID-19 as the general population. Patients treated with an anti-CD20 therapy for a longer period of time might be at a higher risk of COVID-19 and less than 20% generate an antibody response. Only age was related to severity.