Trends in Multiple Sclerosis-related Mortality Among Older Adults Before and After COVID-19: Insights from CDC WONDER
Eiman Zeeshan1, Fnu Javairia2, Javeria Javeid2, Taimoon Rasheed3, Moeen Ikram4, Sarosh Ali5, Aidan Keaveny6, Syed Inam7
1Dow Dental College, 2Allama Iqbal Medical College,Lahore,Pakistan, 3Rawalpini Medical University, 4Frontier Medical And Dental College, 5Services Institute of Medical Sciences, 6Marshall University Joan C Edwards School of Medicine, 7Marshall Neurology
Objective:
This study aims to assess pre-COVID and post-COVID trends in multiple sclerosis (MS) mortality in older adults, highlighting the pandemic’s effects.
Background:
Multiple sclerosis is the leading inflammatory neurological disorder, with a prevalence of 309.2 per 100,000 in the U.S. MS patients are at increased risk for complications from infections, and the advent of COVID-19 has raised concerns regarding its impact on MS mortality.
Design/Methods:
Mortality data were analyzed from the CDC WONDER database for multiple sclerosis patients aged > 45 (ICD-10 code G35) from 1999 to 2022. Pre-COVID data were defined as the period from 1999 to 2019, while post-COVID data were assessed for the years 2020 to 2022. Data were sorted by year, gender, race, census region, and urbanization. We calculated age-adjusted mortality rates (AAMRs) and analyzed average annual percent changes (AAPCs) with 95% confidence intervals using Joinpoint regression.
Results:
A total of 129,309 MS-related deaths occurred in patients aged 45 and older between 1999 and 2022. AAMRs showed no significant change from 1999 to 2019 (AAPC: 0.45); however, there was a sharp increase post-COVID, from 2020 to 2022 (AAPC = 5.71; 95% CI, 2.84–11.17). Females exhibited higher overall AAMRs than males (5.4 vs. 3.2, respectively). During the COVID-19 pandemic, the rise in mortality was more pronounced in females, with an AAPC of 7.09% (95% CI, 4.45–11.24) from 2020 to 2022, compared to males, who experienced a smaller increase with an APC of 4.72% (95% CI, 1.54–12.14). The highest percent changes post-COVID were observed in non-Hispanic (NH) Whites (5.66), followed by Hispanics (5.60) and NH Blacks (4.24).
Conclusions:
Trends indicate that mortality due to MS has seen a sharp spike post-COVID-19, particularly among females and NH White populations. This data can help identify risk factors for MS mortality and guide healthcare interventions and research on the pandemic’s role in MS.
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