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The association of multiple sclerosis, traumatic brain injury, and spinal cord injury to acute and long COVID-19 outcomes. PM R 2024 Jun;16(6):553-562

Date

12/25/2023

Pubmed ID

38145343

Pubmed Central ID

PMC11189756

DOI

10.1002/pmrj.13121

Scopus ID

2-s2.0-85186887247 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

BACKGROUND: Although persons with disabilities are a high-risk group, little is known about the association between specific disabling conditions and acute or long COVID outcomes.

OBJECTIVE: To examine the severity of acute SARS-CoV-2 infection and post-COVID outcomes among people with a preexisting diagnosis of multiple sclerosis (MS), spinal cord injury (SCI), or traumatic brain injury (TBI).

METHODS: This was a retrospective cohort study using the TrinetX Research Database, a large representative database of medical records. COVID-19-positive persons with MS, SCI, or TBI (cases) were matched 1:1 on age, gender, race, ethnicity, and comorbidities to COVID-19-positive persons without these diagnoses (controls). The main outcomes assessed were hospitalization for acute COVID-19, length of stay (LOS), the total number of hospitalizations, mortality, and incidence of six prevalent post-COVID sequelae within 6 months following a COVID-19 diagnosis.

RESULTS: There were 388,297 laboratory-confirmed COVID-19 cases identified. Of these cases, 2204 individuals had one of the following preexisting diagnoses: 51.3% TBI, 31.4% MS, and 17.3% SCI. People with TBI, MS, and SCI were significantly more likely to be hospitalized for COVID-19 (odds ratio [OR] = 1.22, 95% confidence interval [CI] = 1.03-1.46) than matched controls. There was no difference in LOS, total hospitalizations, or mortality during the 6 months following the initial COVID diagnosis. Multivariable analyses reveal that persons with TBI, MS, and SCI were more likely to experience new weakness (OR = 1.54, 95% CI = 1.19-2.00), mobility difficulties (OR = 1.66, 95% CI = 1.17-2.35), and cognitive dysfunction (OR = 1.79, 95% CI = 1.38-2.33) than controls, even after controlling for the presence of these symptoms prior to their COVID infection and other risk factors. There were no differences in fatigue, pain, or dyspnea.

CONCLUSIONS: Having a history of MS, SCI or TBI was not associated with higher mortality risk from COVID-19. However, associations between these diagnoses and postacute COVID-19 symptoms raise concern about widening health outcome disparities for individuals with such potentially disabling conditions following COVID-19 infection.

Author List

Abramoff BA, Hentschel C, Dillingham IA, Dillingham T, Baraniecki-Zwil G, Williams A, Pezzin LE

Author

Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Brain Injuries, Traumatic
Female
Hospitalization
Humans
Length of Stay
Male
Middle Aged
Multiple Sclerosis
Retrospective Studies
Spinal Cord Injuries
United States