Acta clinica Croatica, Vol. 62. No. 4, 2023.
Original scientific paper
https://doi.org/10.20471/acc.2023.62.04.11
Increased Severe COVID-19-Related Fatality in Hospitalized Multiple Sclerosis Patients
Maja Budimkić Stefanović
; Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Jovana Ivanović
; Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia
Olivera Tamaš
; Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Nikola Veselinović
; Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Nikola Momčilović
; Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia
Mirjana Ždraljević
; Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia
Šarlota Mesaroš
; Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Tatjana Pekmezović
; Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Jelena Drulović
; Department of Neurology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
*
* Corresponding author.
Abstract
The aim of this study was to assess the case fatality ratio (CFR) in persons with multiple
sclerosis (PwMS) hospitalized due to severe COVID-19, and to investigate the role of risk factors for
fatal outcome in this well-defined cohort. This case series study included all PwMS (N=32) with severe
COVID-19, who were hospitalized in the COVID-19 referral center in Belgrade from January 2021
to January 2022. Eight out of these 32 patients died from COVID-19 (CFR 25%). The cause of death
was sepsis in 7 patients and pulmonary embolism in one patient. Results of univariate logistic regression
analyses demonstrated that older age, EDSS higher than 6.0, progressive multiple sclerosis (MS) forms,
cardiovascular comorbidities, and longer duration of hospital stay statistically significantly increased the
risk of COVID-19-related death in MS patients. Treatment with ocrelizumab was associated with more
than 2-fold increased death risk (p=0.408). Multivariate logistic regression analysis showed that progressive
forms of MS (p=0.044) and longer hospitalization (p=0.006) significantly increased the risk of death
in our MS cohort. In our study, older age, presence of comorbidities, and progressive disease course were
independent predictors of increased lethality of COVID-19 in PwMS. More intense monitoring may be
warranted in PwMS treated with anti-CD20 agents.
Keywords
Multiple sclerosis; Severe COVID-19; Fatality; Risk factors
Hrčak ID:
320301
URI
Publication date:
31.12.2023.
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