Recovery From COVID-19 in Multiple Sclerosis: A Prospective and Longitudinal Cohort Study of the United Kingdom Multiple Sclerosis Register

Garjani, Afagh; Middleton, Rodden M.; Nicholas, Richard; Evangelou, Nikos

Abstract

Background and Objectives: To understand the course of recovery from coronavirus disease 2019 (COVID-19) among patients with multiple sclerosis (MS) and to determine its predictors, including patients' pre–COVID-19 physical and mental health status.

Methods: This prospective and longitudinal cohort study recruited patients with MS who reported COVID-19 from March 17, 2020, to March 19, 2021, as part of the United Kingdom MS Register (UKMSR) COVID-19 study. Participants used online questionnaires to regularly update their COVID-19 symptoms, recovery status, and duration of symptoms for those who fully recovered. Questionnaires were date stamped for estimation of COVID-19 symptom duration for those who had not recovered at their last follow-up. The UKMSR holds demographic and up-to-date clinical data on participants as well as their web-based Expanded Disability Status Scale (web-EDSS) and Hospital Anxiety and Depression Scale (HADS) scores. The association between these factors and recovery from COVID-19 was assessed using multivariable Cox regression analysis.

Results; Of the 7,977 patients with MS who participated in the UKMSR COVID-19 study, 599 reported COVID-19 and prospectively updated their recovery status. Twenty-eight hospitalized participants were excluded. At least 165 participants (29.7%) had long-standing COVID-19 symptoms for ≥4 weeks and 69 (12.4%) for ≥12 weeks. Participants with pre–COVID-19 web-EDSS scores ≥7, participants with probable anxiety and/or depression (HADS scores ≥11) before COVID-19 onset, and women were less likely to report recovery from COVID-19.

Discussion: Patients with MS are affected by postacute sequelae of COVID-19. Preexisting severe neurologic impairment or mental health problems appear to increase this risk. These findings can have implications in tailoring their post–COVID-19 rehabilitation.

Citation

Garjani, A., Middleton, R. M., Nicholas, R., & Evangelou, N. (2022). Recovery From COVID-19 in Multiple Sclerosis: A Prospective and Longitudinal Cohort Study of the United Kingdom Multiple Sclerosis Register. Neurology, Neuroimmunology and Neuroinflammation, 9(1), Article e1118. https://doi.org/10.1212/nxi.0000000000001118

• Journal Article Type: Article
• Acceptance Date: Oct 6, 2021
• Online Publication Date: Nov 30, 2021
• Publication Date: 2022-01
• Deposit Date: Nov 17, 2021
• Publicly Available Date: Nov 30, 2021
• Journal: Neurology - Neuroimmunology Neuroinflammation
• Electronic ISSN: 2332-7812
• Publisher: Ovid Technologies (Wolters Kluwer Health)
• Peer Reviewed: Peer Reviewed
• Volume: 9
• Issue: 1
• Article Number: e1118
• DOI: https://doi.org/10.1212/nxi.0000000000001118
• Keywords: Neurology (clinical); Neurology
• Public URL: https://nottingham-repository.worktribe.com/output/6727827
• Publisher URL: https://nn.neurology.org/content/9/1/e1118