The field of multiple sclerosis (MS) is in need of a consistent method of measuring smoking to examine its role in disease risk and severity. A pilot study was conducted to examine the association ...between smoking and disease risk in MS cases (n=26) and controls (n=26). Disease severity within MS patients was assessed through clinical and radiological outcomes. These measures were confirmed within a larger dataset of MS patients (n=512) that additionally contained genotyping information. There were no significant differences in disease risk or severity in the pilot study. Within the larger dataset, clinical score trended toward significance (p=0.13). Stratification based on HLA DRB1*1501 status showed that MS smokers with the HLA DRB1*1501 allele had 2.86 greater odds of having more severe clinical disease than nonsmokers with the genotype (1.41, 5.80; p=0.003). To our knowledge, this is the first study to examine smoking and MS disease severity while controlling for genotype.
Objective: To compare the characteristics of patients with rheumatic diseases and COVID-19 reported from Latin American countries with those from the rest of the world. Methods: Patients from the ...COVID-19 Global Rheumatology Alliance Physician-Reported Registry were included. Details regarding demographics, rheumatic disease features, comorbidities, COVID-19 diagnosis and treatment, and outcomes were examined. Chi-squared and t-tests were used to compare associations between groups (Latin America vs. rest of the world). Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of hospitalization (yes/no) and ventilatory support (not hospitalized or supplementary oxygen only vs. non-invasive, invasive ventilation, or ECMO); Poisson models were used to estimate ORs and 95% CIs of mortality. Results: Seventy-four patients from Latin America and 583 patients from the rest of the world were included. The most frequent rheumatic diseases in both groups were rheumatoid arthritis (35% and 39%, respectively) and systemic lupus erythematosus (22% and 14% respectively). Mortality was similar between groups (12% Latin America vs 11% rest of the world, p=0.88. However, Latin American patients in the registry had a higher odds of requiring non-invasive or invasive ventilation, after adjustment OR= 2.29, 95%CI (1.29, 4.07), p less than 0.01.. Conclusion: Latin American patients with rheumatic disease and COVID-19 reported to this global registry presented a higher need for ventilatory support, however experienced a similar mortality than patients from the rest of the world.
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