Does COVID-19 increase the long-term relapsing-remitting multiple sclerosis clinical activity? A cohort study

Area of Science:

• Neurology
• Infectious Diseases
• Epidemiology

Background:

• Emerging evidence suggests a link between COVID-19 and multiple sclerosis (MS) exacerbation.
• Preventing COVID-19 in people with MS (pwMS) is crucial.
• Limited population-based data existed on the long-term effects of COVID-19 on relapsing-remitting MS (RRMS).

Purpose of the Study:

• To investigate potential changes in MS clinical disease activity following COVID-19 infection.
• To assess the long-term impact of COVID-19 on disability progression and relapse rates in pwRRMS.

Main Methods:

• An observational study was conducted at the Isfahan MS clinic from July 2020 to July 2021.
• Compared probable disability progression (PDP) and relapse rates before and after COVID-19 diagnosis in people with RRMS (pwRRMS).
• PDP was defined as a sustained three-month increase in the Expanded Disability Status Scale (EDSS) score.

Main Results:

• Fifty-three pwRRMS with confirmed COVID-19 were analyzed.
• The post-COVID-19 period showed a significantly lower PDP rate (0.06 vs. 0.19, P=0.04) and a non-significantly lower relapse rate (0.21 vs. 0.30, P=0.30) compared to the pre-COVID-19 period.
• Survival analysis and sensitivity analyses did not reveal significant differences in PDP-free or relapse-free survival between the periods.

Conclusions:

• The study's findings did not support an increase in long-term clinical disease activity measures after COVID-19 in pwRRMS.
• Further research is needed to confirm these results in diverse settings.
• The long-term clinical course of RRMS does not appear to be adversely affected by COVID-19 contraction.