Factors associated with the severity of COVID-19 outcomes in people with neuromuscular diseases: Data from the International Neuromuscular COVID-19 Registry

Pizzamiglio, Chiara; Pitceathly, Robert D. S.; Lunn, Michael P.; Brady, Stefen; De Marchi, Fabiola; Galan, Lucia; Heckmann, Jeannine M.; Horga, Alejandro; Molnar, Maria J.; Oliveira, Acary S. B.; Pinto, Wladimir B. V. R.; Primiano, Guido; Santos, Ernestina; Schoser, Benedikt; Servidei, Serenella; Souza, Paulo V. Sgobbi; Venugopalan, Vishnu; Hanna, Michael G.; Dimachkie, Mazen M. und Machado, Pedro M. (2022): Factors associated with the severity of COVID-19 outcomes in people with neuromuscular diseases: Data from the International Neuromuscular COVID-19 Registry. In: European Journal of Neurology, Bd. 30, Nr. 2: S. 399-412

Abstract

Background and purposeClinical outcome information on patients with neuromuscular diseases (NMDs) who have been infected with SARS-CoV-2 is limited. The aim of this study was to determine factors associated with the severity of COVID-19 outcomes in people with NMDs. MethodsCases of NMD, of any age, and confirmed/presumptive COVID-19, submitted to the International Neuromuscular COVID-19 Registry up to 31 December 2021, were included. A mutually exclusive ordinal COVID-19 severity scale was defined as follows: (1) no hospitalization;(2) hospitalization without oxygenation;(3) hospitalization with ventilation/oxygenation;and (4) death. Multivariable ordinal logistic regression analyses were used to estimate odds ratios (ORs) for severe outcome, adjusting for age, sex, race/ethnicity, NMD, comorbidities, baseline functional status (modified Rankin scale [mRS]), use of immunosuppressive/immunomodulatory medication, and pandemic calendar period. ResultsOf 315 patients from 13 countries (mean age 50.3 [+/- 17.7] years, 154 [48.9%] female), 175 (55.5%) were not hospitalized, 27 (8.6%) were hospitalized without supplemental oxygen, 91 (28.9%) were hospitalized with ventilation/supplemental oxygen, and 22 (7%) died. Higher odds of severe COVID-19 outcomes were observed for: age >= 50 years (50-64 years: OR 2.4, 95% confidence interval [CI] 1.33-4.31;>64 years: OR 4.16, 95% CI 2.12-8.15;both vs. <50 years);non-White race/ethnicity (OR 1.81, 95% CI 1.07-3.06;vs. White);mRS moderately severe/severe disability (OR 3.02, 95% CI 1.6-5.69;vs. no/slight/moderate disability);history of respiratory dysfunction (OR 3.16, 95% CI 1.79-5.58);obesity (OR 2.24, 95% CI 1.18-4.25);>= 3 comorbidities (OR 3.2, 95% CI 1.76-5.83;vs. <= 2;if comorbidity count used instead of specific comorbidities);glucocorticoid treatment (OR 2.33, 95% CI 1.14-4.78);and Guillain-Barre syndrome (OR 3.1, 95% CI 1.35-7.13;vs. mitochondrial disease). ConclusionsAmong people with NMDs, there is a differential risk of COVID-19 outcomes according to demographic and clinical characteristics. These findings could be used to develop tailored management strategies and evidence-based recommendations for NMD patients.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1351-5101
• Sprache: Englisch