COVID-19 is associated with new symptoms of multiple sclerosis that are prevented by disease modifying therapies

Garjani, Afagh; Middleton, Rodden M; Hunter, Rachael; Tuite-Dalton, Katherine A; Coles, Alasdair; Dobson, Ruth; Duddy, Martin; Hughes, Stella; Pearson, Owen R; Rog, David; Tallantyre, Emma C; das Nair, Roshan; Nicholas, Richard; Evangelou, Nikos

Abstract

Background

Infections can trigger exacerbations of multiple sclerosis (MS). The effects of the coronavirus disease 2019 (COVID-19) on MS are not known. The aim of this study was to understand the impact of COVID-19 on new and pre-existing symptoms of MS.

Methods

The COVID-19 and MS study is an ongoing community-based, prospective cohort study conducted as part of the United Kingdom MS Register. People with MS and COVID-19 were invited by email to complete a questionnaire about their MS symptoms during the infection. An MS exacerbation was defined as developing new MS symptoms and/or worsening of pre-existing MS symptoms.

Results

Fifty-seven percent (230/404) of participants had an MS exacerbation during their infection; 82 developed new MS symptoms, 207 experienced worsened pre-existing MS symptoms, and 59 reported both. Disease modifying therapies (DMTs) reduced the likelihood of developing new MS symptoms during the infection (OR 0.556, 95%CI 0.316-0.978). Participants with a higher pre-COVID-19 webEDSS (web-based Expanded Disability Status Scale) score (OR 1.251, 95%CI 1.060-1.478) and longer MS duration (OR 1.042, 95%CI 1.009-1.076) were more likely to experience worsening of their pre-existing MS symptoms during the infection.

Conclusion

COVID-19 infection was associated with exacerbation of MS. DMTs reduced the chance of developing new MS symptoms during the infection.

Citation

Garjani, A., Middleton, R. M., Hunter, R., Tuite-Dalton, K. A., Coles, A., Dobson, R., Duddy, M., Hughes, S., Pearson, O. R., Rog, D., Tallantyre, E. C., das Nair, R., Nicholas, R., & Evangelou, N. (2021). COVID-19 is associated with new symptoms of multiple sclerosis that are prevented by disease modifying therapies. Multiple Sclerosis and Related Disorders, 52, Article 102939. https://doi.org/10.1016/j.msard.2021.102939

• Journal Article Type: Article
• Acceptance Date: Apr 5, 2021
• Online Publication Date: May 5, 2021
• Publication Date: 2021-07
• Deposit Date: May 13, 2021
• Publicly Available Date: May 6, 2022
• Journal: Multiple Sclerosis and Related Disorders
• Print ISSN: 2211-0348
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 52
• Article Number: 102939
• DOI: https://doi.org/10.1016/j.msard.2021.102939
• Keywords: Neurology; Clinical Neurology; General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/5527651
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S2211034821002066