COVID‐19 clinical outcomes and DMT of MS patients and population‐based controls
Abstract Objective To estimate risks for all‐cause mortality and for severe COVID‐19 in multiple sclerosis patients and across relapsing–remitting multiple sclerosis patients exposed to disease‐modifying therapies. Methods We conducted a Swedish nationwide population‐based multi‐register linkage coh...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-09-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.51646 |
| _version_ | 1828412029037182976 |
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| author | Elisa Longinetti Hannah Bower Kyla A McKay Simon Englund Joachim Burman Katharina Fink Anna Fogdell‐Hahn Martin Gunnarsson Jan Hillert Annette Langer‐Gould Jan Lycke Petra Nilsson Jonatan Salzer Anders Svenningsson Johan Mellergård Tomas Olsson Fredrik Piehl Thomas Frisell |
| author_facet | Elisa Longinetti Hannah Bower Kyla A McKay Simon Englund Joachim Burman Katharina Fink Anna Fogdell‐Hahn Martin Gunnarsson Jan Hillert Annette Langer‐Gould Jan Lycke Petra Nilsson Jonatan Salzer Anders Svenningsson Johan Mellergård Tomas Olsson Fredrik Piehl Thomas Frisell |
| author_sort | Elisa Longinetti |
| collection | DOAJ |
| description | Abstract Objective To estimate risks for all‐cause mortality and for severe COVID‐19 in multiple sclerosis patients and across relapsing–remitting multiple sclerosis patients exposed to disease‐modifying therapies. Methods We conducted a Swedish nationwide population‐based multi‐register linkage cohort study and followed all multiple sclerosis patients (n = 17,692 in March 2020), individually age‐, sex‐, and region‐matched to five population‐based controls (n = 86,176 in March 2020) during March 2020–June 2021. We compared annual all‐cause mortality within and across cohorts, and assessed incidence rates and relative risks for hospitalization, intensive care admission, and death due to COVID‐19 in relation to disease‐modifying therapy use, using Cox regression. Results Absolute all‐cause mortality among multiple sclerosis patients was higher from March to December 2020 than in previous years, but relative risks versus the population‐based controls were similar to preceding years. Incidence rates of hospitalization, intensive care admission, and death due to COVID‐19 remained in line with those for all‐cause hospitalization, intensive care admission, and mortality. Among relapsing–remitting patients on rituximab, trends for differences in risk of hospitalization due to COVID‐19 remained in the demographics‐, socioeconomic status‐, comorbidity‐, and multiple sclerosis severity‐adjusted model. Interpretation Risks of severe COVID‐19‐related outcomes were increased among multiple sclerosis patients as a whole compared to population controls, but risk increases were also seen for non‐COVID‐19 hospitalization, intensive care admission, and mortality, and did not significantly differ during the pandemic compared to pre‐pandemic years. The risk conveyed by disease‐modifying therapies was smaller than previously assumed, likely as a consequence of the possibility to better control for confounders. |
| first_indexed | 2024-12-10T12:40:50Z |
| format | Article |
| id | doaj.art-f5e46de376404433ae57cd4c2d571b4d |
| institution | Directory Open Access Journal |
| issn | 2328-9503 |
| language | English |
| last_indexed | 2024-12-10T12:40:50Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj.art-f5e46de376404433ae57cd4c2d571b4d2022-12-22T01:48:32ZengWileyAnnals of Clinical and Translational Neurology2328-95032022-09-01991449145810.1002/acn3.51646COVID‐19 clinical outcomes and DMT of MS patients and population‐based controlsElisa Longinetti0Hannah Bower1Kyla A McKay2Simon Englund3Joachim Burman4Katharina Fink5Anna Fogdell‐Hahn6Martin Gunnarsson7Jan Hillert8Annette Langer‐Gould9Jan Lycke10Petra Nilsson11Jonatan Salzer12Anders Svenningsson13Johan Mellergård14Tomas Olsson15Fredrik Piehl16Thomas Frisell17Department of Clinical Neuroscience Karolinska Institutet Stockholm SwedenClinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Stockholm SwedenDepartment of Clinical Neuroscience Karolinska Institutet Stockholm SwedenDepartment of Clinical Neuroscience Karolinska Institutet Stockholm SwedenDepartment of Neuroscience Uppsala University Uppsala SwedenDepartment of Clinical Neuroscience Karolinska Institutet Stockholm SwedenDepartment of Clinical Neuroscience Karolinska Institutet Stockholm SwedenDepartment of Neurology Örebro University Örebro SwedenDepartment of Clinical Neuroscience Karolinska Institutet Stockholm SwedenClinical and Translational Neuroscience Southern California Permanente Medical Group, Kaiser Permanente Los Angeles USADepartment of Clinical Neuroscience University of Gothenburg Gothenburg SwedenDepartment of Clinical Sciences Division of Neurology, Lund University Lund SwedenDepartment of Clinical Sciences Neurosciences, Umeå University Umeå SwedenDepartment of Clinical Sciences Danderyd Hospital, Karolinska Institutet Stockholm SwedenDepartment of Biomedical and Clinical Sciences Linköping University Linköping SwedenDepartment of Clinical Neuroscience Karolinska Institutet Stockholm SwedenDepartment of Clinical Neuroscience Karolinska Institutet Stockholm SwedenClinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet Stockholm SwedenAbstract Objective To estimate risks for all‐cause mortality and for severe COVID‐19 in multiple sclerosis patients and across relapsing–remitting multiple sclerosis patients exposed to disease‐modifying therapies. Methods We conducted a Swedish nationwide population‐based multi‐register linkage cohort study and followed all multiple sclerosis patients (n = 17,692 in March 2020), individually age‐, sex‐, and region‐matched to five population‐based controls (n = 86,176 in March 2020) during March 2020–June 2021. We compared annual all‐cause mortality within and across cohorts, and assessed incidence rates and relative risks for hospitalization, intensive care admission, and death due to COVID‐19 in relation to disease‐modifying therapy use, using Cox regression. Results Absolute all‐cause mortality among multiple sclerosis patients was higher from March to December 2020 than in previous years, but relative risks versus the population‐based controls were similar to preceding years. Incidence rates of hospitalization, intensive care admission, and death due to COVID‐19 remained in line with those for all‐cause hospitalization, intensive care admission, and mortality. Among relapsing–remitting patients on rituximab, trends for differences in risk of hospitalization due to COVID‐19 remained in the demographics‐, socioeconomic status‐, comorbidity‐, and multiple sclerosis severity‐adjusted model. Interpretation Risks of severe COVID‐19‐related outcomes were increased among multiple sclerosis patients as a whole compared to population controls, but risk increases were also seen for non‐COVID‐19 hospitalization, intensive care admission, and mortality, and did not significantly differ during the pandemic compared to pre‐pandemic years. The risk conveyed by disease‐modifying therapies was smaller than previously assumed, likely as a consequence of the possibility to better control for confounders.https://doi.org/10.1002/acn3.51646 |
| spellingShingle | Elisa Longinetti Hannah Bower Kyla A McKay Simon Englund Joachim Burman Katharina Fink Anna Fogdell‐Hahn Martin Gunnarsson Jan Hillert Annette Langer‐Gould Jan Lycke Petra Nilsson Jonatan Salzer Anders Svenningsson Johan Mellergård Tomas Olsson Fredrik Piehl Thomas Frisell COVID‐19 clinical outcomes and DMT of MS patients and population‐based controls Annals of Clinical and Translational Neurology |
| title | COVID‐19 clinical outcomes and DMT of MS patients and population‐based controls |
| title_full | COVID‐19 clinical outcomes and DMT of MS patients and population‐based controls |
| title_fullStr | COVID‐19 clinical outcomes and DMT of MS patients and population‐based controls |
| title_full_unstemmed | COVID‐19 clinical outcomes and DMT of MS patients and population‐based controls |
| title_short | COVID‐19 clinical outcomes and DMT of MS patients and population‐based controls |
| title_sort | covid 19 clinical outcomes and dmt of ms patients and population based controls |
| url | https://doi.org/10.1002/acn3.51646 |
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