INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Majestic Complex (Posters 61-120) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #91 COVID-19 Disease Outcomes and Acute Neuropsychiatric Symptoms Among Patients with Multiple Sclerosis Christine Cherian, Rutgers University, New Brunswick, United States Anjali Patel, Rutgers University, New Brunswick, United States Michelle Chen, Rutgers University, New Brunswick, United States Category: Multiple Sclerosis/ALS/Demyelinating Disorders Keyword 1: multiple sclerosis Keyword 2: infectious disease Keyword 3: neuropsychiatry Objective: To evaluate whether patients with multiple sclerosis (MS) experience worse COVID-19 disease outcomes and have more acute neuropsychiatric complications following COVID-19 infection compared to neurologically healthy individuals using the National COVID Cohort Collaborative (N3C). The N3C represents the largest cohort of COVID-19 cases, through the unification of electronic health records (EHR) from over 60 medical centers. Participants and Methods: Out of 5,631,225 COVID-19 positive cases, we identified a subset of patients with a previous MS diagnosis. We then used propensity score matching based on gender, race, and age to find a control group who were neurologically healthy prior to their COVID-19 diagnosis (MS to controls matched 1:3). Cox proportional hazards and ordinal regression models were run to evaluate group differences in the risk for more severe COVID-19 disease outcomes, including hospitalization, disease severity, mortality, and long COVID diagnosis. Additionally, we identified 15 acute neuropsychiatric complications associated with COVID-19 that are commonly reported in the literature. Logistic regressions were performed to examine group differences in the development of these complications. Results: In our final dataset of COVID-19 positive patients, there were 14,851 patients who had a prior MS diagnosis and 44,553 patients who were previously neurologically healthy that were matched to our MS cohort. Patients with MS had a higher risk of hospitalization (31.53% vs. 19.66%; odds ratio: 1.13, p<0.001), mortality (1.75% vs. 1.01%; odds ratio: 1.45, p<0.001), and long COVID diagnosis (1.32% vs. 0.49%; odds ratio: 1.99, p<0.001) compared to patients without MS. Patients with MS also had more severe COVID-19 disease course compared to patients without MS (9.89 vs. 4.68 with moderate to severe disease; p<0.001). Finally, patients with MS had a higher risk of developing each of the 15 neuropsychiatric complications, excluding agnosia and smell & taste disorder, compared to non-MS patients. Mood disorder was the most prevalent neuropsychiatric sequelae in both cohorts, with the MS group being three times more likely to develop the condition (12% vs. 3%; odds ratio: 2.872, p<0.001), followed by, headache (8.6% vs. 3.6%; odds ratio: 1.940, p<0.001), insomnia (3.4% vs. 1.2%; odds ratio: 2.078, p<0.001), neuralgia (2.4% vs. 0.2%; odds ratio: 12.234, p<0.001), and encephalopathy (2.8% vs. 0.7%, odds ratio: 3.134, p<0.001). Conclusions: Using a large multi-center EHR sample, the current study demonstrated that patients with MS have a higher risk of worse COVID-19 disease outcomes and acute neuropsychiatric complications. Therefore, medical providers should be more aware of the higher risk MS patients face with a COVID-19 diagnosis and adjust their treatment plans accordingly.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #91

COVID-19 Disease Outcomes and Acute Neuropsychiatric Symptoms Among Patients with Multiple Sclerosis

Christine Cherian, Rutgers University, New Brunswick, United States
Anjali Patel, Rutgers University, New Brunswick, United States
Michelle Chen, Rutgers University, New Brunswick, United States

Category: Multiple Sclerosis/ALS/Demyelinating Disorders

Keyword 1: multiple sclerosis
Keyword 2: infectious disease
Keyword 3: neuropsychiatry

Objective:

To evaluate whether patients with multiple sclerosis (MS) experience worse COVID-19 disease outcomes and have more acute neuropsychiatric complications following COVID-19 infection compared to neurologically healthy individuals using the National COVID Cohort Collaborative (N3C). The N3C represents the largest cohort of COVID-19 cases, through the unification of electronic health records (EHR) from over 60 medical centers.

Participants and Methods:

Out of 5,631,225 COVID-19 positive cases, we identified a subset of patients with a previous MS diagnosis. We then used propensity score matching based on gender, race, and age to find a control group who were neurologically healthy prior to their COVID-19 diagnosis (MS to controls matched 1:3). Cox proportional hazards and ordinal regression models were run to evaluate group differences in the risk for more severe COVID-19 disease outcomes, including hospitalization, disease severity, mortality, and long COVID diagnosis. Additionally, we identified 15 acute neuropsychiatric complications associated with COVID-19 that are commonly reported in the literature. Logistic regressions were performed to examine group differences in the development of these complications.

Results:

In our final dataset of COVID-19 positive patients, there were 14,851 patients who had a prior MS diagnosis and 44,553 patients who were previously neurologically healthy that were matched to our MS cohort. Patients with MS had a higher risk of hospitalization (31.53% vs. 19.66%; odds ratio: 1.13, p<0.001), mortality (1.75% vs. 1.01%; odds ratio: 1.45, p<0.001), and long COVID diagnosis (1.32% vs. 0.49%; odds ratio: 1.99, p<0.001) compared to patients without MS. Patients with MS also had more severe COVID-19 disease course compared to patients without MS (9.89 vs. 4.68 with moderate to severe disease; p<0.001). Finally, patients with MS had a higher risk of developing each of the 15 neuropsychiatric complications, excluding agnosia and smell & taste disorder, compared to non-MS patients. Mood disorder was the most prevalent neuropsychiatric sequelae in both cohorts, with the MS group being three times more likely to develop the condition (12% vs. 3%; odds ratio: 2.872, p<0.001), followed by, headache (8.6% vs. 3.6%; odds ratio: 1.940, p<0.001), insomnia (3.4% vs. 1.2%; odds ratio: 2.078, p<0.001), neuralgia (2.4% vs. 0.2%; odds ratio: 12.234, p<0.001), and encephalopathy (2.8% vs. 0.7%, odds ratio: 3.134, p<0.001).

Conclusions:

Using a large multi-center EHR sample, the current study demonstrated that patients with MS have a higher risk of worse COVID-19 disease outcomes and acute neuropsychiatric complications. Therefore, medical providers should be more aware of the higher risk MS patients face with a COVID-19 diagnosis and adjust their treatment plans accordingly.