Sars-CoV2 infection in pregnant women with multiple sclerosis

Aprea, Maria Grazia;Schiavetti, Irene;Portaccio, Emilio;Ballerini, Chiara;Battaglia, Mario Alberto;Bergamaschi, Roberto;Brichetto, Giampaolo;Bunul, S Destan;Calabrese, Massimiliano;Capobianco, Marco;Cavalla, Paola;Celani, Maria Grazia;Clerico, Marinella;Cocco, Eleonora;Comi, Giancarlo;Confalonieri, Paolo;Conte, Antonella;Cordioli, Cinzia;De Luca, Giovanna;De Rossi, Nicola;Filippi, Massimo;Gumes, Haluk;Immovilli, Paolo;Inglese, Matilde;Karabudak, Rana;Landi, Doriana;Lanzillo, Roberta;L'Episcopo, Maria Rita;Lorefice, Lorena;Mantero, Vittorio;Marangoni, Sabrina;Marfia, Girolama Alessandra;Masciulli, Camilla;Milano, Eva;Moiola, Lucia;Orlandi, Riccardo;Patti, Francesco;Perini, Paola;Pesci, Ilaria;Pucci, Eugenio;Puthenparampil, Marco;Radaelli, Marta;Salvetti, Marco;Sartori, Arianna;Scandellari, Cinzia;Sen, Sedat;Siva, Aksel;Strumia, Silvia;Teatini, Francesco;Tedeschi, Gioacchino;Trojano, Maria;Tutuncu, Melih;Vaula, Giovanna;Sormani, Maria Pia;Amato, Maria Pia

2023-01-01

---

Abstract

Background: In the general population, maternal SARS-CoV-2 infection during pregnancy is associated with worse maternal outcomes; however, only one study so far has evaluated COVID-19 clinical outcomes in pregnant and postpartum women with multiple sclerosis, showing no higher risk for poor COVID-19 outcomes in these patients. Objective: In this multicenter study, we aimed to evaluate COVID-19 clinical outcomes in pregnant patients with multiple sclerosis. Methods: We recruited 85 pregnant patients with multiple sclerosis who contracted COVID-19 after conception and were prospectively followed-up in Italian and Turkish Centers, in the period 2020-2022. A control group of 1354 women was extracted from the database of the Multiple Sclerosis and COVID-19 (MuSC-19). Univariate and subsequent logistic regression models were fitted to search for risk factors associated with severe COVID-19 course (at least one outcome among hospitalization, intensive care unit [ICU] admission and death). Results: In the multivariable analysis, independent predictors of severe COVID-19 were age, body mass index ⩾ 30, treatment with anti-CD20 and recent use of methylprednisolone. Vaccination before infection was a protective factor. Vaccination before infection was a protective factor. Pregnancy was not a risk nor a protective factor for severe COVID-19 course. Conclusion: Our data show no significant increase of severe COVID-19 outcomes in patients with multiple sclerosis who contracted the infection during pregnancy.