COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Background and objectives: It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19-related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population. Methods: Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1,362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score > 3 or at least 1 comorbidity, lower risk: EDSS score ≤ 3 and no comorbidities) by the χ2 test, and the risk excess was quantified by risk ratios (RRs). Results: The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization (p < 0.001), RR = 2.19 for ICU admission (p < 0.001), and RR = 2.43 for death (p < 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04). Discussion: Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon

DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39–3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18–0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

Selfie and the city: A world-wide, large, and ecologically valid database reveals a two-pronged side bias in nai[[ampi]]die;ve self-portraits

Self-portraits are more likely to show the artist's right than left cheek. This phenomenon may have a psychobiological basis: Self-portraitists often copy their subject from mirrors and, if they prefer to present their left cheek (more expressive due to right-lateralization of emotions) to the mirror, this would result in a right-cheek bias in the painting. We tested this hypothesis using SelfieCity (3200 selfies posted on Instagram from December 4 through 12, 2013 from New York, Sao Paulo, Berlin, Moskow, and Bangkok), which includes two selfie-taking styles: a "standard" (photograph of selfie-taker) and a "mirror" (photograph of mirror reflection of selfie-taker) style. We show that the first style reveals a left cheek bias, whereas the second reveals a right cheek bias. Thus side biases observed in a world-wide, large, and ecologically valid database of naïve self-portraits provide strong support for a role of psychobiological factors in the artistic composition of self-portraits

Counts of the five posing categories in our re-analysis of the SelfieCity database.

<p>Counts of the five posing categories in our re-analysis of the SelfieCity database.</p

Results

<p>Frequencies of selfies showing the right (purple) or left (pale blue) cheek (a) in the SelfieCity database, as a function of selfie-taker sex (b), selfie-taking style (c), and city of origin (d). Only selfies that were coded as unambiguously showing one cheek more than the other were included in this analysis (about 2400 selfies, see text for details).</p