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COVID-19-Related Outcomes in Primary Mitochondrial Diseases: An International Study

Pizzamiglio, Chiara; Machado, Pedro M; Thomas, Rhys H; Gorman, Gráinne S; McFarland, Robert; Hanna, Michael G; Pitceathly, Robert DS; (2022) COVID-19-Related Outcomes in Primary Mitochondrial Diseases: An International Study. Neurology 10.1212/WNL.0000000000200240. (In press). Green open access

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Abstract

OBJECTIVES: To identify factors associated with severe COVID-19, defined by hospitalization status, in patients with primary mitochondrial diseases (PMDs), thereby enabling future risk stratification and informed management decisions. METHODS: We undertook a cross-sectional, international, registry-based study. Data was extracted from the "International Neuromuscular COVID-19 Database" and collected between 1st May 2020 and 31st May 2021. The database included subjects with: 1) PMD diagnosis (any age), clinically/histopathologically suspected and/or genetically confirmed; and (2) COVID-19 diagnosis classified as "confirmed", "probable", or "suspected" based on World Health Organization definitions. The primary outcome was hospitalization due to COVID-19. We collected demographic information, smoking status, coexisting comorbidities, outcome following COVID-19 infection, and PMD genotype-phenotype. Baseline status was assessed using the modified Rankin scale (mRS) and the Newcastle Mitochondrial Disease Adult Scale (NMDAS). RESULTS: Seventy-nine subjects with PMDs from 10 countries were included (mean age 41.5±18 years): 25 (32%) were hospitalized; 48 (61%) recovered fully; 28 (35%) improved with sequelae; and three (4%) died. Statistically significant differences in hospitalization status were observed in: baseline status, including NMDAS score (p=0.003) and mRS (p=0.001); presence of respiratory dysfunction (p<0.001), neurologic involvement (p=0.003); and more than four comorbidities (p=0.002). In multivariable analysis, respiratory dysfunction was independently associated with COVID-19 hospitalization (OR, 7.66; 95%CI, 2 to 28; p=0.002). DISCUSSION: Respiratory dysfunction is an independent risk factor for severe COVID-19 in PMDs, while high disease burden and coexisting comorbidities contribute towards COVID-19 related hospitalization. These findings will enable risk stratification and informed management decisions for this vulnerable population.

Type: Article
Title: COVID-19-Related Outcomes in Primary Mitochondrial Diseases: An International Study
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1212/WNL.0000000000200240
Publisher version: https://doi.org/10.1212/WNL.0000000000200240
Language: English
Additional information: © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (http://creativecommons.org/licenses/by/4.0/).
Keywords: MitoCOVID-19 Study Group
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/10144420
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