COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Background: It is unclear how multiple sclerosis (MS) affects the severity of Covid-19. Methods: Hospitalization, Intensive Care Unit (ICU) admission and death after Covid-19 diagnosis 1362 MS patients were compared to age sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs expected events whole cohort different subgroups (higher-risk: EDSS>3 or at least one comorbidity, lower-risk: EDSS<=3 no comorbidities) by chi-square test risk excess was quantified Risk Ratios (RR). Findings: severe about twice population: RR=2·12 for hospitalization (p<0·001), RR=2·19 ICU (p<0·001) RR=2·43 (p<0·001). confined higher-risk group (n=553). In lower-risk (n=809) rate close that (RR=1·12 hospitalization, RR=1·52 admission, RR=1·19 death). group, an increased detected on anti-CD20 (RR=3·03, p=0·005), while decrease interferon (0 4 events, p=0·04). Interpretation: Overall had population. This mainly explained EDSS comorbidities, residual increase therapies people interferon. Funding Information: None. Declaration Interests: MP. Sormani reports grants from Roche, during conduct study; personal fees Biogen, Merck, Sanofi, Novartis, Medday, Geneuro, Celgene, Mylan outside submitted work. N. De Rossi received speaker honoraria Biogen Idec, Genzyme, Sanofi-Aventis; funding participation advisory board Genzyme-Sanofi travel scientific meetings Teva, Sanofi-Genzyme, Almirall Novartis. M Filippi Editor-in-Chief Journal Neurology, Associate Editor Human Brain Mapping, Radiology, Neurological Sciences; compensation consulting services and/or speaking activities Alexion, Almirall, Bayer, Eli Lilly, Merck-Serono, Takeda, Teva Pharmaceutical Industries; receives research support Industries, Ministry Health, Fondazione Italiana Sclerosi Multipla, ARiSLA (Fondazione di Ricerca per la SLA). He speaker’s following companies: TEVA. M. Radaelli Novartis Merck Serono Serono, Roche. P. Immovilli work. M. Capobianco non-financial work. P. Confalonieri has consultation attend Roche. also institutional Merk-Serono, principal investigator clinical trials Roche. M.Inglese NIH, DOD, NMSS, FISM, Neuroscience; participating boards Genzyme. M. Trojano TEVA, null, work. G. Comi Industries Ltd, Italia Srl, Sanofi Genzyme Corporation, Europe, KGgA, SpA, Celgene Group, F. Hoffman-La Roche Forward Pharma, Excemed, work. F. Patti Onlus association, University Catania, Salvetti Multiple Sclerosis Foundation, Sapienza Rome, work. I .Schiavetti, L. Carmisciano, C. Cordioli, G Brichetto, E Cocco, P Cavalla, I Pesci, A Zito, GA Marfia, Perini, V Brescia Morra, G. Tedeschi, Scandellari, M. Battaglia have nothing disclose. Ethics Approval Statement: approved Regional Ethics Committee Liguria (University Genoa) (n 130/2020 – DB id 10433) national level Agenzia del Farmaco (AIFA).