Affiliation:
1. Tehran University of Medical Sciences
2. Tehran University of Medical Sciences (TUMS)
Abstract
Abstract
Background: This study aimed to evaluate the efficacy and safety concerns of remdesivir and type 1 interferons (INFs) on the clinical outcomes of multiple sclerosis (MS) patients who were hospitalized with COVID-19.
Methods: Using electronic health records systems, this is a cross-sectional study of two years of hospital admissions in terms of COVID-19 in Iran from March 2019 to August 2021. The severities of COVID-19 outcomes were ICU admission, hospitalization days, and 30-day mortality rates.
Results: Nine hundred ninety-nine hospitalized MS patients with a definite diagnosis of COVID-19 based on PCR were recorded in the electronic health systems. Almost half of the patients were under treatment with an anti-CD-20 agent (rituximab or ocrelizumab) at the time of hospital admission (50.3%), with higher mortality rates, needing ICU admission, and longer hospitalization (p<0.05).
There was a significant association between taking IFN alone (adjusted IRR=1.21, 95% CI 1.32 to 1.42) or in combination with RDV (adjusted IRR=1.30, 95% CI 1.18 to 1.5042) and longer hospitalization.
There were no significant associations between antiviral treatment (RDV alone, IFNβ1 alone, and IFNβ1 plus RDV) and ICU admission (p>0.2), in-hospital mortality rate (p>0.2), or 30-day survival rate (p>0.2). The results were similar in patients who did or did not receive anti-CD-20 agents.
Conclusion: Our data reveal that RDV, IFN, or a combination of IFN and RDV administration has no benefit in the treatment of hospitalized MS patients with COVID-19.
Publisher
Research Square Platform LLC
Reference31 articles.
1. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/. Accessed July 21.
2. COVID-19 in ocrelizumab-treated people with multiple sclerosis;Hughes R;Multiple Scler Relat disorders,2021
3. Multiple Sclerosis Management During the COVID-19 Pandemic;Hollen C;Curr Neurol Neurosci Rep,2022
4. Association between disease-modifying therapies and adverse clinical outcomes in multiple sclerosis patients with COVID-19 infection;Maghbooli Z;Multiple Scler Relat disorders,2022
5. Prolonged and severe SARS-CoV-2 infection in patients under B-cell-depleting drug successfully treated: A tailored approach;D'Abramo A;Int J Infect diseases: IJID : official publication Int Soc Infect Dis,2021