J. Halper

CMSC
June Halper is a certified adult nurse practitioner who has specialized in multiple sclerosis for many years. She is the Chief Executive Officer of the Consortium of Multiple Sclerosis Centers (CMSC) and the IOMSN. Ms. Halper has published and lectured extensively on multiple sclerosis and its ramifications. Her numerous publications include Comprehensive Nursing Care in Multiple Sclerosis and Advanced Concepts in Nursing Care in Multiple Sclerosis, co-editor of Staying Well with Multiple Sclerosis: A Self-Care Guide, and co-editor of Nursing Practice in Multiple Sclerosis: A Core Curriculum. She is a member of the American Academy of Nurse Practitioners, the founding director of IOMSN, the International Organization of MS Nurses, and the recipient of the IOMSN’s first June Halper Award for Excellence in Nursing in Multiple Sclerosis. She was inducted as a Fellow into the American Academy of Nursing in November 1999. In 2000, she spearheaded the establishment of the Multiple Sclerosis International Credentialing Board who developed the first international certification examination in multiple sclerosis nursing offered in June 2002 and bi-annually thereafter. As CEO of the CMSC, she initiated the first certification examination for MS specialists in 2004. As early as 1995, Ms. Halper was involved in the development of clinical practice guidelines in multiple sclerosis which were multi-organization collaborative projects. She was involved in the publication of guidelines in bladder dysfunction in MS, fatigue in MS, spasticity in MS, immunizations in MS, and disease modification in MS. Subsequently the CMSC has adopted a best practices model and Ms. Halper was involved in publication of models of comprehensive care, complex symptomatic management, and cognition to name a few publications. (please visit www.mscare.org for a full listing) The NARCOMS and NARCRMS patient registries were established under Ms. Halper’s leadership and support. Both are have become sources of information about epidemiologic information about multiple sclerosis.

Author Of 1 Presentation

 Program
COVID-19 Late Breaking Abstracts

SS02.02 - Comparison of COVID-19 outcomes between racial groups in the COViMS registry

Speakers
Authors
Presentation Number
SS02.02
Presentation Topic
COVID-19
Lecture Time
10:57 - 11:09

Abstract

Background

Risk factors previously identified for worse outcomes with SARS-CoV-2 infections include older age, male sex and specific comorbid conditions. An increased risk for poorer COVID-19 outcomes in people with multiple sclerosis (MS) are similar to the general population, but less is known about outcomes in minority groups with MS.

Objectives

To evaluate differences in outcomes of SARS-CoV-2 infection in non-Hispanic White and Black persons with multiple sclerosis.

Methods

COViMS is a North American registry for health care providers to report persons with MS who are infected with SARS-CoV-2, the virus that causes COVID-19 (cases). Cases are reported after 7 days and when the outcome of infection is reasonably certain. MS and clinically isolated syndrome cases were categorized using the Center for Disease Control and Prevention races (non-Hispanic Whites, and Black). Comorbidities related to COVID-19 outcomes were collected. Clinical outcomes examined were mortality alone, mortality and/or admissions to the intensive care unit (ICU) and mortality, ICU admissions and/or hospitalization. Age-adjusted mortality rates as of August 3, 2020 and 95% confidence intervals (CI) were calculated. Multivariable logistic regression was used to assess adjusted differences between races using odds ratios (OR) and 95% CIs. Covariates included sex, age, smoking (current, past, never), MS clinical course (relapsing, progressive), disease duration, ambulation (fully ambulatory, walks with assistance, non-ambulatory), individual comorbidities (cardiovascular disease, cerebrovascular disease, chronic kidney disease, chronic lung disease, diabetes, hypertension, morbid obesity), and disease modifying therapy use (yes vs no).

Results

Of 734 patients reported, 421 (57.4%) Whites, and 194 (26.5%) Black patients were reported. Black cases were more likely to be younger (p=0.002), never smokers (p=0.002), have shorter MS duration (p<0.001), a relapsing MS course (p=0.03) and have comorbidities (p<0.001) compared to Whites. A higher proportion of Black patients had hypertension (40.2% vs 19.5%, p<0.001), and morbid obesity (17.0% vs 9.5%, p=0.007). Mortality rates increased with age and were not statistically different between Whites and Blacks (p=0.156). Black race was associated with increased odds of mortality and/or ICU admission (OR 3.8 [95%CI: 1.60, 8.96], p=0.002) and mortality, ICU admission and/or hospitalization (OR 2.0 [95%CI: 1.14, 3.54], p=0.016) after adjustment for covariates.

Conclusions

Within the COViMS registry, Black MS patients were younger and more likely to have comorbidities than White MS patients. Black MS patients had an increased risk for poorer outcomes compared to Whites even after adjusting for comorbidities at the time of COVID-19.

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Moderator Of 1 Session

 Program
Nurse's Session Sat, Sep 12, 2020

NS01 - Advanced nursing activities

Moderators
Session Type
Nurse's Session
Date
Sat, Sep 12, 2020
Time (ET)
11:00 - 12:30