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. [Molnár, Mária Judit (Neurológia), szerző] Genomikai Medicina és
Ritka Betegségek Intézete (SE / AOK / I); 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.; Machado, Pedro M. ✉; Neuromuscular Dis COVID-19 Study G [Kollaborációs szervezet]
Angol nyelvű Sokszerzős vagy csoportos szerzőségű szakcikk (Folyóiratcikk) Tudományos
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.
