Neurological sequela of COVID-19 in adults with multiple sclerosis
BACKGROUND
Possible interactions in neuropsychiatric presentations of multiple sclerosis (MS) and COVID-19 may occur, which has been proposed in previous, albeit limited, literature.
OBJECTIVES
Examine COVID-19 disease outcomes and changes in neuropsychiatric symptoms among patients with MS.
METHODS
A retrospective cohort study using electronic medical records from the National COVID Cohort Collaborative (N3C) database was conducted. 26,963 adults with MS diagnosed with COVID-19 were included in the study, and propensity score matched to 80,889 neurologically healthy adults with COVID-19. Group differences in risk for general COVID-19 disease outcomes, 15 acute COVID-19-associated neuropsychiatric complications, and 6 chronic MS-associated neuropsychiatric symptoms were assessed.
RESULTS
Patients with MS were at a higher risk for mortality; hospitalization; long-COVID diagnosis; more severe COVID-19 disease; 9 of the 15 acute complications, including cognitive impairment (OR: 4.059, p < 0.001), neuralgia (OR: 3.961, p < 0.001), dysautonomia (OR: 2.740, p < 0.008), and paresthesia (OR: 2.522, p < 0.001); and 5 of the 6 chronic symptoms, including cognitive impairment (OR: 2.945, p < 0.001), fatigue (OR: 2.190, p < 0.001), and depression (OR: 1.345, p < 0.001).
CONCLUSIONS
Patients with MS are at risk for adverse COVID-19 outcomes. This warrants heightened caution in this population when managing COVID-19 infections.
HIGHLIGHTS
• Large MS and COVID-19 Cohort: This study analyzed over 26,000 adults with multiple sclerosis (MS) and with around 80,000 matched controls using the National COVID Cohort Collaborative (N3C), which is the largest electronic health record dataset of COVID-19 patients in the United States.
• Increased risk of hospitalization, mortality, long COVID, and severe COVID-19 disease in MS patients compared to neurologically healthy adults.
• Increased risk for acute neuropsychiatric complications associated with COVID-19 infection in MS patients compared to neurologically health cohorts.
• MS patients showed higher odds of developing chronic MS-associated neuropsychiatric conditions following a COVID-19 infection, compared to neurologically healthy controls.
Web | DOI | PDF | Multiple Sclerosis and Related Disorders | Open Access
Anjali Patel; Christine Cherian; Derek Ge; Sabiha Hussain; Carol Shu; Michelle H Chen
BACKGROUND
Possible interactions in neuropsychiatric presentations of multiple sclerosis (MS) and COVID-19 may occur, which has been proposed in previous, albeit limited, literature.
OBJECTIVES
Examine COVID-19 disease outcomes and changes in neuropsychiatric symptoms among patients with MS.
METHODS
A retrospective cohort study using electronic medical records from the National COVID Cohort Collaborative (N3C) database was conducted. 26,963 adults with MS diagnosed with COVID-19 were included in the study, and propensity score matched to 80,889 neurologically healthy adults with COVID-19. Group differences in risk for general COVID-19 disease outcomes, 15 acute COVID-19-associated neuropsychiatric complications, and 6 chronic MS-associated neuropsychiatric symptoms were assessed.
RESULTS
Patients with MS were at a higher risk for mortality; hospitalization; long-COVID diagnosis; more severe COVID-19 disease; 9 of the 15 acute complications, including cognitive impairment (OR: 4.059, p < 0.001), neuralgia (OR: 3.961, p < 0.001), dysautonomia (OR: 2.740, p < 0.008), and paresthesia (OR: 2.522, p < 0.001); and 5 of the 6 chronic symptoms, including cognitive impairment (OR: 2.945, p < 0.001), fatigue (OR: 2.190, p < 0.001), and depression (OR: 1.345, p < 0.001).
CONCLUSIONS
Patients with MS are at risk for adverse COVID-19 outcomes. This warrants heightened caution in this population when managing COVID-19 infections.
HIGHLIGHTS
• Large MS and COVID-19 Cohort: This study analyzed over 26,000 adults with multiple sclerosis (MS) and with around 80,000 matched controls using the National COVID Cohort Collaborative (N3C), which is the largest electronic health record dataset of COVID-19 patients in the United States.
• Increased risk of hospitalization, mortality, long COVID, and severe COVID-19 disease in MS patients compared to neurologically healthy adults.
• Increased risk for acute neuropsychiatric complications associated with COVID-19 infection in MS patients compared to neurologically health cohorts.
• MS patients showed higher odds of developing chronic MS-associated neuropsychiatric conditions following a COVID-19 infection, compared to neurologically healthy controls.
Web | DOI | PDF | Multiple Sclerosis and Related Disorders | Open Access