Having MS Did Not Increase Risk of Severe COVID-19 in German Study

Margarida Maia, PhD avatar

by Margarida Maia, PhD |

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People with multiple sclerosis (MS) are not at greater risk for severe COVID-19 outcomes, according to a study of more than 150,000 hospitalized people in Germany.

The study, “Multiple sclerosis is not associated with an increased risk for severe COVID-19: a nationwide retrospective cross-sectional study from Germany,” was published in Neurological Research and Practice.

Since the early stages of the pandemic, researchers have been trying to determine who may be at a higher risk of a severe disease course. While having MS does not appear to raise the chances of developing COVID-19, some factors, such as the use of immunosuppressive medications, may contribute to worse outcomes.

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To investigate the impact of MS on COVID-19 outcomes, researchers in Germany examined the medical records of all patients who required hospitalization for COVID-19 in the country in 2020.

From a total of 157,524 patients who were hospitalized for COVID-19, 551 (0.3%) had a diagnosis of MS. Among them, 106 had relapsing-remitting MS, 99 had secondary progressive MS, 76 had primary progressive MS, and 270 had unspecified MS.

Compared with other patients, MS patients were generally younger (60.6 vs. 66.9 years) and had a higher proportion of women (62.8% vs. 48.2%).

When the researchers compared COVID-19 outcomes between the two groups, people with MS were found to have lower rates of admission to the ICU (17.1% vs. 22.7%), lower use of ventilation (9.8% vs. 14.5%), and lower in-hospital mortality (11.1% vs. 19.3%) than people who did not have MS.

However, because age, sex, and MS subtype could be confounding the results, the researchers conducted additional analyses to account for these factors.

The researchers found the results were affected not by sex and MS type — meaning that MS patients had better COVID-19 outcomes, regardless of their sex or disease subtype — but by age. When age was considered in the analyses, in-hospital mortality was similar in people with and without MS.

The researchers wrote that the lack of information about the degree of disability in MS patients and about the recent use of immunosuppressive medications is a limitation of the study, as both have been linked to worse outcomes of COVID-19.

Nevertheless, “simply having MS does not increase the likelihood of a severe course of COVID-19 compared to patients without comorbid MS,” the researchers concluded.

“The knowledge of MS-associated risk factors is vital to help clinicians identify patients at higher risk for a severe course of COVID-19,” they added. “Future studies should also question the incidence and impact of Long-COVID syndromes in patients with comorbid MS.”

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