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Mitochondrial disease and COVID-19: An international cohort study confirms risks and long-term outcomes

2021; Elsevier BV; Volume: 429; Linguagem: Inglês

10.1016/j.jns.2021.119358

1878-5883

Chiara Pizzamiglio, Hallgeir Jonvik, Stefen Brady, Patrick F. Chinnery, Lucı́a Galan, Gráinne S. Gorman, Alejandro Horga, Rita Horváth, Mirian C. H. Janssen, Albert Lim, Michelangelo Mancuso, Robert McFarland, Mária Judit Molnár, Olimpia Musumeci, Victoria Nesbitt, Wladimir, Guido Primiano, Ernestina Santos, Serenella Servidei, Rhys H. Thomas, Michael G. Hanna, Pedro Machado, Robert D. S. Pitceathly,

Mitochondrial Function and Pathology

Coronavirus 2019 (COVID-19), with more than 3 million deaths worldwide, is one of the deadliest pandemics in history. Patients with primary mitochondrial diseases (PMDs) are considered at high risk of complications. However, little is known about how COVID-19 affects this group. The aim of our study was to: (1) identify risk factors associated with hospitalisation; and (2) determine outcomes and long-term sequelae of COVID-19 in people with PMDs. Inclusion criteria included: (1) clinicopathological and/or genetically confirmed PMDs at any age; and (2) COVID-19 infection with compatible symptoms and/or positive PCR testing. Data concerning the underlying diagnosis and COVID-19 infection were anonymously collated by physicians worldwide. The primary outcome was hospitalisation due to COVID-19. Univariable analysis and multivariable-adjusted logistic regression were subsequently applied to data. Seventy-two subjects with PMDs from nine countries were included in the study (mean age 41.3 ± 18.2 years); 22 (30.6%) were hospitalised; 43 (59.7%) recovered fully; 25 (34.7%) resolved with sequelae (global deterioration of PMD in six cases, long-COVID-19 in 19 cases); and three (4.2%) died. Statistically significant differences in hospitalisation status were observed for: (1) age (p = 0.005); (2) Newcastle Mitochondrial Disease Adult Scale score (p = 0.003); (3) modified Rankin scale before COVID-19 (p = 0.03); (4) respiratory (p < 0.001) and skeletal muscle weakness (p = 0.004); (5) wheelchair dependence (p = 0.005); and (6) gastrointestinal dysmotility (p = 0.002). Our study confirms the PMD patients most vulnerable to COVID-19 related hospitalisation, thus helping stratify risk and appropriate management. Long-term sequelae, including worsening of the pre-existing PMD and "long COVID-19 symptoms", were a frequent finding in our cohort.