Abstract Details

Title Modifiable Risk Factors of COVID-19 in Patients with Multiple Sclerosis: A Single-Centre Case-Control Study

Topic General Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-029

Objective To assess risk factors associated with SARS-CoV-2 infection among patients with multiple sclerosis (PwMS).

Background Disease- and treatment-associated immune system abnormalities may confer a higher risk of SARS-CoV-2 infection to PwMS.

Design/Methods Among patients referring to the MS Center of IRCCS San Raffaele Hospital, we retrospectively collected epidemiological, clinical, and laboratory data of PwMS who got a confirmed COVID-19 infection between March 2020 and March 2021 (MS-COVID, n=149). Afterwards, we pursued a 1:2 matching of a control group by collecting data of PwMS without a history suggestive of previous COVID-19 infection (MS-NCOVID, n=292). MS-COVID and MS-NCOVID patients were matched for age, EDSS, and line of treatment. All participants were not vaccinated against SARS-CoV-2 at the time of the evaluation. We compared neurological examination, premorbid vitamin D levels, anthropometric variables such as BMI, life-style habits (smoke), working-activity, and living environment (number of cohabitants) between the two groups. COVID-19 severity was evaluated in terms of typical symptoms, fever, radiological pneumonia, and hospitalization. Logistic regression and Bayesian network analyses were used to evaluate the association with the development of COVID-19.

Results Higher levels of vitamin D (OR=0.94, p<0.001, adjusted p<0.001) and positive smoking status (OR=0.49, p<0.001, adjusted p<0.001) emerged as protective factors against SARS-CoV-2 infection. In contrast, higher number of cohabitants (OR=1.36, p<0.001, adjusted p<0.001) and works requiring direct external contact (OR=2.34, p<0.001, adjusted p=0.004) or in the healthcare sector (OR=3.55, p<0.001, adjusted p=0.004) resulted risk factors for COVID-19 disease. Bayesian network analysis showed that patients working in the healthcare sector, and therefore exposed to increased risk of COVID-19, were usually non-smokers, possibly explaining the protective association between active smoking and COVID-19.

Conclusions

This case-control study underlines the importance of constant monitoring and supplementation of Vitamin D in PwMS. In the case of pandemic conditions, teleworking may prevent unnecessary risk of infection in these patients.

Authors/Disclosures
Federico Montini (Brigham and Women's hospital - Harvard Medical School) PRESENTER	Mr. Montini has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Lucia Moiola, MD, PhD (Fondazione Centro San Raffaele)	Dr. Moiola has nothing to disclose.
Federica Esposito	Federica Esposito has received personal compensation in the range of $0-$499 for serving as a Consultant for Merck. Federica Esposito has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Federica Esposito has received personal compensation in the range of $0-$499 for serving as a Consultant for Novartis. Federica Esposito has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Federica Esposito has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. The institution of Federica Esposito has received research support from Italian MS Society. The institution of Federica Esposito has received research support from Italian Ministry of Health. The institution of Federica Esposito has received research support from ERA Net. The institution of Federica Esposito has received research support from European Commission. Federica Esposito has received intellectual property interests from a discovery or technology relating to health care.
	No disclosure on file
Maria A. Rocca (Neuroimaging Research Unit)	Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Vittorio Martinelli (S. Raffaele Hospital)	Dr. Martinelli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis, Biogen, Sanofi Genzyme, TEVA and Merck. Dr. Martinelli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck .

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