The impact of COVID-19 infection on multiple sclerosis disease course across 12 countries: a propensity-score-matched cohort study, 2024, Levitz et al

The impact of COVID-19 infection on multiple sclerosis disease course across 12 countries: a propensity-score-matched cohort study
David Levitz, Anneke Van Der Walt et 39 al

BACKGROUND
The relationship between coronavirus disease 2019 (COVID-19) infection and multiple sclerosis (MS) relapse and disease progression remains unclear. Previous studies are limited by small sample sizes and most lack a propensity-matched control cohort.

OBJECTIVES
To evaluate the effect of COVID-19 infection on MS disease course with a large propensity-matched cohort.

DESIGN
This multi-centre cohort study analysed relapse and disability outcomes postCOVID-19 infection after balancing covariates using a propensity score matching method. The study period was from the 11th of September 2019 to the 16th of February 2023. The mean follow-up period was 1.7 years.

METHODS
Data were retrieved from the MSBase Registry. Propensity scores were obtained based on age, sex, disease duration, baseline Expanded Disability Status Scale (EDSS), MS course, relapses pre-baseline, disease-modifying therapy (DMT) class and country. Primary outcomes were time to first relapse, annualised relapse rate (ARR) and time to confirm EDSS progression. Secondary outcomes were time to EDSS of 3, 4 or 6. Sensitivity analyses with baseline DMT classes were performed.

RESULTS
The study included 2253 cases and 6441 controls. After matching, there were 2161 cases and an equal number of matched controls. Cases had a significantly higher ARR (ARR = 0.10 [95% CI 0.09–0.11]) compared to controls (ARR = 0.07 [95% CI 0.06–0.08]). Cases had a significantly greater hazard of time to first relapse compared to controls (hazard ratio (HR) = 1.54 [95% CI 1.29–1.84]). There was no association between COVID-19 infection and 24-week EDSS progression (HR = 1.18 [95% CI 0.92–1.52]), or time to EDSS of 3, 4 or 6. For patients on interferons and glatiramer acetate (BRACE), COVID-19 infection was associated with a greater hazard of time to first relapse (HR = 1.83 [95% CI 1.25–2.68]) and greater hazard of time to EDSS of 3 (HR = 2.04 [95% CI 1.06–3.90]) compared to patients on BRACE therapy without COVID-19 infection.

CONCLUSIONS
COVID-19 infection was associated with a significantly increased MS relapse rate and a shorter time to first relapse. There was no effect on confirmed EDSS progression over the short term. These results support ongoing COVID-19 risk minimisation strategies to protect patients with MS.

Link | PDF (Therapeutic Advances in Neurological Disorders) [Open Access]

 

These results support ongoing COVID-19 risk minimisation strategies to protect patients with MS.

What would these be?

Cause hospitals and doctors surgeries are plague ridden and the doctors and nurses and administrators all seem fine with this, ventilation no one knows how to open the windows if there even are any, no plans to update the air conditioning or even pop in some free standing air purifiers over here in England and I think our authorities might benefit from some advice here or a little refresher course on infection control measures maybe….