Ambulatory disability and older age are associated with worse clinical severity of COVID-19, including death, among patients with multiple sclerosis (MS), according to a study published online March 19 in JAMA Neurology.
Amber Salter, Ph.D., from the Washington University School of Medicine in St. Louis, and colleagues examined outcomes and risk factors associated with COVID-19 clinical severity in a cohort of 1,626 patients with MS. Patients were assessed after a minimum of seven days from initial symptom onset and after sufficient time had passed to observe the COVID-19 disease course through resolution of acute illness or death. Clinical outcome was classified with four levels of severity: not hospitalized, hospitalization only, admission to intensive care unit/required ventilator support, and death.
The researchers found that the overall mortality rate was 3.3 percent in the cohort. After adjustment for other risk factors, both ambulatory disability and older age were independently associated with elevated odds of all clinical severity levels compared with those not hospitalized (being nonambulatory: odds ratios: 2.8, 3.5, and 25.4 for hospitalization only, intensive care unit/required ventilator support, and death, respectively; age [every 10 years]: odds ratios, 1.3, 1.3, and 1.8, for hospitalization only, intensive care unit/required ventilator support, and death, respectively).
“Knowledge of these risk factors may enable clinicians caring for patients with MS to improve monitoring and treatment of COVID-19,” the authors write.
Several authors disclosed financial ties to the biopharmaceutical industry.