We report on 111 patients with MS and related disorders (MSRD) with COVID-19.
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36.9% of MSRD patients had neurologic worsening after COVID-19.
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Neurologic worsening was associated with hospitalization for COVID-19.
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Neurologic worsening was not associated with age, sex, EDSS, race or disease type.
Abstract
Background
Neurologic outcomes in patients with multiple sclerosis (MS) and related disorders (MSRD) following COVID-19 is not well understood. The objective of this study was to investigate neurologic outcomes in patients with MSRD post-COVID-19.
Methods
This was a retrospective medical records review study of adult patients with MSRD and COVID-19 infection at the Brigham MS Center. Neurologic worsening post-COVID-19 was defined as having a relapse, pseudorelapse, new brain MRI activity, worsening of preexisting MSRD symptoms, or development of other long-term neurologic symptoms.
Results
111 patients, 85 (76.6%) females, with a mean [SD] age of 49.3 [12.2] years and median [range] EDSS of 2.5 [0, 8.5] were identified. 41 patients (36.9%) had neurologic worsening post-COVID-19. Of those, 19 (46.3%) had pseudorelapses, 2 (4.8%) had relapses, and 24 (58.5%) patients reported worsening of preexisting MSRD symptoms, or other new long-term neurologic symptoms. Neurologic worsening was associated with hospitalized (moderate or severe) COVID-19 (p = 0.001), treatment for COVID-19 (p = 0.006), and incomplete COVID-19 recovery (p = 0.0267) but not with age, sex, MS type, race, disease duration, EDSS, vitamin D use, or disease modifying therapy use.
Conclusions
COVID-19 severity and lack of complete systemic recovery were associated with new or worsening neurologic symptoms in 36.9% of MSRD patients.
Keywords
Multiple sclerosis
Clinical outcomes
COVID-19
Abbreviations
CDC
Centers for Disease Control and Prevention
CIS
Clinically isolated syndrome
CLIMB
Comprehensive Longitudinal Investigation of multiple sclerosis database at Brigham and Women's hospital
