SARS-CoV-2 infection increases long-term multiple sclerosis disease activity and all-cause mortality in an underserved inner-city population

Hadidchi, Roham; Wang, Stephen H.; Rezko, David; Henry, Sonya; Coyle, Patricia K.; Duong, Tim Q.

doi:10.1016/j.msard.2024.105613

Cited by 4 publications

(5 citation statements)

References 44 publications

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“…We have previously shown that at our institution 10 , patients with pre-existing MS who tested positive for SARS-CoV-2 and survived the acute infection experienced elevated long-term risk of mortality and optic neuritis compared to those without a documented history of COVID-19.…”

Section: Discussionmentioning

confidence: 91%

“…This EMR data in the OMOP CDM format was exported and queried as SQLite database les using the DB Browser for SQLite (version 3.12.2). Data were extracted as described previously 10,[25][26][27][28][29][30][31][32][33][34] . Please refer to Supplementary Table 1 for a list of concept names and concept IDs used in this study.…”

Section: Data Sourcesmentioning

confidence: 99%

“…COVID-19 survivors with pre-existing neurological conditions are likely to be more susceptible to acute viral infection, associated dysregulated immune response, and metabolic and cardiovascular distress. Pathologic in ammation has been suggested to exacerbate immune-mediated neurotoxicity or increase immune cell permeability across the blood-brain barrier, leading to worse long-term outcomes in patients with MS [7][8][9][10] . Aβ pathology and certain APOE variants in patients with AD and other forms of dementia may strengthen the binding of the SARS-CoV-2 spike protein to ACE2 receptors 11,12 .…”

Section: Introductionmentioning

confidence: 99%

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Long-Term outcomes of patients with a pre-existing neurological condition after SARS-CoV-2 infection

Hadidchi,

Al-Ani,

Choi

et al. 2024

Preprint

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Objectives. This study investigated post COVID-19 outcomes of patients with pre-existing neurological conditions up to 3.5 years post-infection. Methods. This retrospective study consisted of 1,664 patients with COVID-19 (of which 1,320 had been hospitalized for acute COVID-19) and 8,985 non-COVID patients from the Montefiore Health System in the Bronx (Jan-2016 to Jul-2023). Primary outcomes were all-cause mortality and major adverse cardiovascular events (MACE) post-COVID-19. Secondary outcomes were depression, anxiety, fatigue, headache, sleep disturbances, altered mental status, and dyspnea post-COVID-19. Cox proportional hazards model was used to calculate adjusted hazard ratios for all-cause mortality and major adverse cardiovascular event (MACE). Cumulative incidence function and Fine-Gray sub-distribution hazards model analysis were performed for secondary outcomes. Results. Patients with a neurological disease hospitalized for COVID-19 were more likely to die (adjusted HR = 1.92 [CI:1.60, 2.30], P < 0.005), whereas patients non-hospitalized for COVID-19 had mortality rate (aHR = 1.08 [CI:0.65, 1.81], P = 0.76), compared to non-COVID patients. Patients with a neurological disease (hospitalized for COVID-19 aHR = 1.76 [CI:1.53, 2.03], P < 0.005; not hospitalized for COVID-19: aHR = 1.50 [CI:1.09, 2.05], P = 0.01) were more likely to experience a MACE compared to non-COVID patients. Notably Blacks (aHR = 1.49) and Hispanics (aHR = 1.35) had a higher risk of post COVID-19 MACE. Both hospitalized and non-hospitalized COVID-19 patients were more likely to develop higher cumulative incidence of altered mental status, fatigue, sleep disturbance, dyspnea compared to non-COVID patients (p < 0.05). Conclusions. Patients with pre-existing neurological conditions who contracted COVID-19 were more likely to have worse outcomes compared to controls. Identifying at-risk individuals could enable more diligent follow-up.

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Section: Discussionmentioning

confidence: 91%

Section: Data Sourcesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-Term outcomes of patients with a pre-existing neurological condition after SARS-CoV-2 infection

Hadidchi,

Al-Ani,

Choi

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

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“…Higher incidences of diabetes [ 70 , 71 , 72 ], hypertension [ 73 ], and kidney disorders [ 74 , 75 ], among others, have been reported in individuals post-COVID-19 compared to non-COVID matched controls. Worsening of disease progression of existing clinical disorders has been reported in patients with hypertension [ 76 , 77 ], kidney disease [ 78 ], multiple sclerosis [ 79 , 80 , 81 , 82 , 83 , 84 ], dementia [ 85 , 86 , 87 ], and other neurological conditions [ 86 , 87 , 88 , 89 , 90 , 91 ] post-COVID-19 compared to non-COVID matched controls. We expect that there will be accelerated aging of multiorgan systems in some individuals, especially those with experience of severe acute COVID-19 and/or with major pre-existing comorbidities.…”

Section: Resultsmentioning

confidence: 99%

A Comprehensive Review of the Global Epidemiology, Clinical Management, Socio-Economic Impacts, and National Responses to Long COVID with Future Research Directions

Song,

Cui

et al. 2024

Diagnostics

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Background: Long COVID, characterized by a persistent symptom spectrum following SARS-CoV-2 infection, poses significant health, social, and economic challenges. This review aims to consolidate knowledge on its epidemiology, clinical features, and underlying mechanisms to guide global responses; Methods: We conducted a literature review, analyzing peer-reviewed articles and reports to gather comprehensive data on long COVID’s epidemiology, symptomatology, and management approaches; Results: Our analysis revealed a wide array of long COVID symptoms and risk factors, with notable demographic variability. The current understanding of its pathophysiology suggests a multifactorial origin yet remains partially understood. Emerging diagnostic criteria and potential therapeutic strategies were identified, highlighting advancements in long COVID management; Conclusions: This review highlights the multifaceted nature of long COVID, revealing a broad spectrum of symptoms, diverse risk factors, and the complex interplay of physiological mechanisms underpinning the condition. Long COVID symptoms and disorders will continue to weigh on healthcare systems in years to come. Addressing long COVID requires a holistic management strategy that integrates clinical care, social support, and policy initiatives. The findings underscore the need for increased international cooperation in research and health planning to address the complex challenges of long COVID. There is a call for continued refinement of diagnostic and treatment modalities, emphasizing a multidisciplinary approach to manage the ongoing and evolving impacts of the condition.

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“…Higher incidences of diabetes [68][69][70], hypertension [71], kidney disorders [72,73] among others have been reported in individuals post COVID-19 compared to non-COVID matched controls. Worsening of disease progression of existing clinical disorders have been reported in patients with hypertension [74,75], kidney disease [76], multiple sclerosis [77][78][79][80][81][82], dementia [83][84][85] and other neurological conditions [84][85][86][87][88][89] post COVID-19 compared to non-COVID matched controls. We expect that there will be accelerated aging of multiorgan systems in some individuals, especially those experienced severe acute COVID-19 and/or with major pre-existing comorbidities.…”

Section: New Clinical Disorders and Accelerated Disease Progressionmentioning

confidence: 99%

A Comprehensive Global Review of Epidemiology, Clinical Management, Socio-Economic Impacts and National Responses of Long COVID with Future Research Directions

Song,

Cui

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Long COVID, characterized by a persistent symptom spectrum following SARS-CoV-2 infection, poses significant health, social, and economic challenges. This review aims to consolidate knowledge on its epidemiology, clinical features, and underlying mechanisms to guide global responses; Methods: We conducted a systematic literature review, analyzing peer-reviewed articles and reports to gather comprehensive data on long COVID’s epidemiology, symptomatology, and management approaches; Results: Our analysis revealed a wide array of long COVID symptoms and risk factors, with notable demographic variability. The current understanding of its pathophysiology suggests a multifactorial origin yet remains partially understood. Emerging diagnostic criteria and potential therapeutic strategies were identified, highlighting advancements in long COVID management.; Conclusion: This review highlights the multifaceted nature of long COVID, revealing a broad spectrum of symptoms, diverse risk factors, and the complex interplay of physiological mechanisms underpinning the condition. Long COVID symptoms and disorders will continue to weigh on healthcare systems in years to come. Ad-dressing long COVID requires a holistic management strategy that integrates clinical care, social support, and policy initiatives. The findings underscore the need for increased international cooperation in research and health planning to address the complex challenges of long COVID. There is a call for continued refinement of diagnostic and treatment modalities, emphasizing a multidisciplinary approach to manage the ongoing and evolving impacts of the condition.

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SARS-CoV-2 infection increases long-term multiple sclerosis disease activity and all-cause mortality in an underserved inner-city population

Cited by 4 publications

References 44 publications

Long-Term outcomes of patients with a pre-existing neurological condition after SARS-CoV-2 infection

Long-Term outcomes of patients with a pre-existing neurological condition after SARS-CoV-2 infection

A Comprehensive Review of the Global Epidemiology, Clinical Management, Socio-Economic Impacts, and National Responses to Long COVID with Future Research Directions

A Comprehensive Global Review of Epidemiology, Clinical Management, Socio-Economic Impacts and National Responses of Long COVID with Future Research Directions

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