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. 2022 Dec;29(12):3728-3736.
doi: 10.1111/ene.15554. Epub 2022 Sep 23.

Signs and symptoms of COVID-19 in patients with multiple sclerosis

Irene Schiavetti  1 , Luca Carmisciano  1 , Marta Ponzano  1 , Cinzia Cordioli  2 , Eleonora Cocco  3   4 , Girolama Alessandra Marfia  5 , Matilde Inglese  6   7 , Massimo Filippi  8   9   10   11   12 , Marta Radaelli  13 , Roberto Bergamaschi  14 , Paolo Immovilli  15 , Marco Capobianco  16 , Nicola De Rossi  2 , Giampaolo Brichetto  17 , Cinzia Scandellari  18 , Paola Cavalla  19 , Ilaria Pesci  20 , Paolo Confalonieri  21 , Paola Perini  22 , Maria Trojano  23 , Roberta Lanzillo  24 , Gioacchino Tedeschi  25 , Giancarlo Comi  26 , Mario Alberto Battaglia  27   28 , Francesco Patti  29   30 , Marco Salvetti  31   32 , Maria Pia Sormani  1   7 ; MuSC-19 Study Group
Collaborators, Affiliations

Signs and symptoms of COVID-19 in patients with multiple sclerosis

Irene Schiavetti et al. Eur J Neurol. 2022 Dec.

Abstract

Background and purpose: Clinical outcomes of multiple sclerosis (MS) patients affected by coronavirus disease 2019 (COVID-19) have been thoroughly investigated, but a further analysis on main signs and symptoms and their risk factors still needs attention. The objective of this study was to group together and describe based on similarity the most common signs and symptoms of COVID-19 in MS patients and identify all factors associated with their manifestation.

Method: Logistic and linear regression models were run to recognize factors associated with each pooled group of symptoms and their total number.

Results: From March 2020 to November 2021, data were collected from 1354 MS patients with confirmed infection of COVID-19. Ageusia and anosmia was less frequent in older people (odds ratio [OR] 0.98; p = 0.005) and more in smoker patients (OR 1.39; p = 0.049). Smoke was also associated with an incremental number of symptoms (OR 1.24; p = 0.031), substance abuse (drugs or alcohol), conjunctivitis and rash (OR 5.20; p = 0.042) and the presence of at least one comorbidity with shortness of breath, tachycardia or chest pain (OR 1.24; p = 0.008). Some disease-modifying therapies were associated with greater frequencies of certain COVID-19 symptoms (association between anti-CD20 therapies and increment in the number of concomitant symptoms: OR 1.29; p = 0.05). Differences in frequencies between the three waves were found for flu-like symptoms (G1, p = 0.024), joint or muscle pain (G2, p = 0.013) and ageusia and anosmia (G5, p < 0.001). All cases should be referred to variants up to Delta.

Conclusion: Several factors along with the choice of specific therapeutic approaches might have a different impact on the occurrence of some COVID-19 symptoms.

Keywords: COVID-19; demyelinating diseases; disease-modifying treatment; multiple sclerosis; neurological disorders.

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Conflict of interest statement

Schiavetti I received consulting fees from Hippocrates Research, NovaNeuro, Sakura Italia, ADL Farmaceutici, Associazione Commissione Difesa Vista Onlus. Carmisciano L has nothing to disclose. Ponzano M has nothing to disclose. Inglese M received research grants from NIH, DOD, NMSS, FISM, and Teva Neuroscience; received fees for participating in advisory boards from Roche, Biogen, Merck and Genzyme. Radaelli M received speaker honoraria from Biogen Idec, Sanofi‐Genzyme, Novartis and Merck Serono and funding for travel to scientific meetings from Biogen Idec, Sanofi‐Genzyme, Novartis, Merck Serono, Teva and Roche. De Rossi N received speaker honoraria from Biogen Idec, Genzyme, Novartis, Sanofi‐Aventis; received funding for participation in advisory board to Novartis, Biogen and Genzyme‐Sanofi and for travel to scientific meetings from Biogen Idec, Teva, Sanofi‐Genzyme, Roche, Almirall and Novartis. Immovilli P reports personal fees from Roche, personal fees from Biogen, personal fees from Merck, outside the submitted work. Capobianco M reports personal fees and non‐financial support from Biogen, personal fees and non‐financial support from Merck Serono, personal fees and non‐financial support from Roche, personal fees and non‐financial support from Novartis, personal fees and non‐financial support from Sanofi, personal fees from Almirall, outside the submitted work. Confalonieri Phas received honoraria for speaking or consultation fees from Novartis and Biogen, has received funding for travel to attend scientific events or speaker honoraria from Merck Serono, Biogen Idec, Teva and Roche. He has also received institutional research support from Merk‐Serono, Novartis and Roche. He is also principal investigator in clinical trials for Biogen, Merck Serono, Roche. Perini P has received honoraria for lectures and support for attending meetings and travel from Roche, Biogen, Merck, Novartis, Sanofi, Teva. Trojano M reports grants and personal fees from Biogen, grants and personal fees from Novartis, grants and personal fees from Roche, grants and personal fees from Merck, personal fees from Sanofi, personal fees from TEVA, from null, outside the submitted work. Comi G reports personal fees from Novartis, Teva Pharmaceutical Industries Ltd, Teva Italia Srl, Sanofi Genzyme, Genzyme Corporation, Genzyme Europe, Merck KGgA, Merck Serono SpA, Celgene Group, Biogen Idec, Biogen Italia Srl, F. Hoffman‐La Roche, Roche SpA, Almirall SpA, Forward Pharma, Medday, Excemed, outside the submitted work. Patti F reports grants from Biogen, grants from Merck, grants from FISM, grants from Onlus association, grants from University of Catania, personal fees from Almirall, personal fees from Bayer, personal fees from Biogen, personal fees from Merck, personal fees from Roche, personal fees from Sanofi, personal fees from TEVA, outside the submitted work. Salvetti M reports grants and personal fees from Biogen, grants and personal fees from Merck, grants and personal fees from Novartis, grants and personal fees from Roche, grants and personal fees from Sanofi, grants and personal fees from Teva, grants from Italian Multiple Sclerosis Foundation, grants from Sapienza University of Rome, outside the submitted work. Sormani MP reports grants from Roche, during the conduct of the study; personal fees from Biogen, Merck, Roche, Sanofi, Novartis, Medday, Geneuro, Celgene, Mylan outside the submitted work.

Figures

FIGURE 1
FIGURE 1
Frequency of single symptoms and grouped symptoms
FIGURE 2
FIGURE 2
Heat map of correlation, as measured by odds ratio estimates, between factors and each symptom group. Values above 1 (shade of red) indicate risk factors, below 1 (shade of green) protective factors
FIGURE 3
FIGURE 3
Distribution of symptom groups over time, with identification of the three pandemic waves
See this image and copyright information in PMC

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