Risk factors of severe COVID-19 in people with multiple sclerosis : A systematic review and meta-analysis

• Published in: Revue neurologique Vol. 178; no. 1-2; pp. 121 - 128
• Main Authors: Etemadifar, M., Nouri, H., Maracy, M.R., Akhavan Sigari, A., Salari, M., Blanco, Y., Sepúlveda, M., Zabalza, A., Mahdavi, S., Baratian, M., Sedaghat, N.
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.01.2022
• Subjects: Adult; Aged; COVID-19; Disease-modifying therapies; Humans; Male; Meta-analysis; Multiple sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - diagnosis; Multiple Sclerosis - epidemiology; Original; Risk Factors; SARS-CoV-2; COVID-19; Multiple sclerosis; Disease-modifying therapies; Meta-analysis
• ISSN: 0035-3787; 0035-3787
• DOI: 10.1016/j.neurol.2021.10.003

To gather, synthesize, and meta-analyze data regarding the risk factors associated with a severe course of COVID-19 among patients with multiple sclerosis (pwMS). MEDLINE, Embase, Scopus, and WoS were searched in May 2021. Briefly, the eligibility criteria included: 1) studies assessing COVID-19 severity among adult pwMS; 2) definitive diagnoses or high clinical suspicion of COVID-19; 3) a categorization of COVID-19 severity into at least two categories; 4) quantitative effect size and precision measurements; and 5) English language; and 6) clear effect size/precision measures. internal validity of studies was assessed using the NIH Quality Assessment Tools. A list of possible risk factors was created based on the search results and was later used in extraction, synthesis, and meta-analysis of the data. Thirteen studies were included in the syntheses. Outcome measures were either extracted from the papers, obtained from the primary researchers or calculated manually. The meta-analyses showed a significantly (P<0.05) increased odds of a severe COVID-19 in pwMS with all of the assessed risk factors, except smoking and most DMTs. This study facilitates evidence-based risk/benefit assessments in practice. Older men with progressive MS on anti-CD20 therapies are more at risk of an unfortunate COVID-19 outcome.