Related Experiment Video
Updated: Jul 15, 2025
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Patients with multiple sclerosis: COVID-19 related disease activity and hospitalisations based on a nationwide cohort
Mette Louise Andersen1, Floor Dijkstra Zegers1, Line Riis Jølving1
1Center for Clinical Epidemiology, Odense University Hospital, Kløvervænget 30, Entrance 216, 5000, Odense C, Denmark; Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern, Kløvervænget 30, Entrance 216, 5000, Odense C, Denmark.
Insights
COVID-19 did not increase multiple sclerosis disease activity. However, patients with multiple sclerosis faced a higher risk of hospitalization with COVID-19 within 30 days of a positive test, regardless of treatment.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- The impact of COVID-19 on multiple sclerosis (MS) disease activity and hospitalization risk remains unclear.
- This study investigates the association between COVID-19 infection and MS disease activity proxies, such as corticosteroid use and neurological hospital contacts.
- It also examines the risk of COVID-19 hospitalization in MS patients compared to other autoimmune disease patients and the general population.
Purpose of the Study:
- To determine if COVID-19 triggers disease activity in multiple sclerosis patients.
- To assess the risk of hospitalization with COVID-19 in multiple sclerosis patients.
- To evaluate the effect of disease-modifying treatments on COVID-19 hospitalization risk in MS patients.
Main Methods:
- Nationwide health registries analyzed data from 2,222,946 individuals with positive COVID-19 PCR tests.
- Disease activity proxies (corticosteroid prescriptions, neurological admissions) were compared pre- and post-COVID-19 infection in MS patients.
- Logistic regression models estimated hospitalization odds ratios for MS patients relative to autoimmune disease patients and the general population, adjusting for confounders.
Main Results:
- COVID-19 infection did not significantly alter corticosteroid prescription rates (aIRR 0.93) or neurological hospital contacts for MS (aIRR 1.10).
- MS patients had a significantly higher risk of COVID-19 hospitalization within 30 days post-infection (aOR 3.21 vs. other autoimmune diseases; aOR 5.34 vs. general population).
- Disease-modifying treatment use did not increase the risk of COVID-19 hospitalization (aOR 0.94).
Conclusions:
- COVID-19 infection does not appear to trigger disease activity in multiple sclerosis patients.
- Multiple sclerosis patients face a substantially increased risk of hospitalization due to COVID-19.
- Disease-modifying treatments do not elevate the risk of COVID-19 hospitalization in multiple sclerosis patients.
Background:
It has not previously been clarified if COVID-19 triggers disease activity and increases the risk of hospitalisation with COVID-19 in patients with multiple sclerosis. We examined the association between COVID-19 and the use of systemic corticosteroids prescriptions and hospital contacts at neurological departments as proxies of disease activity among patients with multiple sclerosis. Furthermore, we examined whether patients with multiple sclerosis were more likely to be hospitalised with COVID-19 compared to references.
Methods:
This study was based on nationwide health registries with data on the Danish population of 2,222,946 individuals with a positive COVID-19 PCR test. To study disease activity our study population consisted of all patients with multiple sclerosis and a positive COVID-19 PCR test. Our proxies for disease activity were compared after versus before a positive COVID-19 PCR test using a binomial regression model. Adjustments were made for age, sex, comorbidity, length of multiple sclerosis diagnosis, calendar period, vaccination, and immunomodulatory treatment. To study the risk of hospitalisation with COVID-19 in patients with multiple sclerosis our study population here consisted of all Danish citizens with a COVID-19 positive PCR test. In logistic regression models we estimated odds ratio (OR) for hospitalisation with COVID-19 in patients with multiple sclerosis relative to patients affected with other autoimmune diseases (inflammatory bowel disease/rheumatoid arthritis), and relative to individuals from the general population. Adjustments were made for age, sex, comorbidity, vaccination, and calendar period. To examine the impact of disease-modifying treatment, the risk of hospitalisation with COVID-19 was estimated in those with disease-modifying treatment versus those without any disease-modifying treatment.
Results:
We included 7358 patients with multiple sclerosis and a positive COVID-19 PCR test. The adjusted incidence rate ratio (aIRR) for having corticosteroid prescriptions after COVID-19 in patients with multiple sclerosis was 0.93 (95 % CI 0.78 - 1.10), and the aIRR for hospital contacts at neurological departments/admissions with multiple sclerosis as primary diagnosis after COVID-19 infection was 1.10 (95 % 1.00-1.22). Adjusted OR (aOR) for hospitalisation with COVID-19 in the 30 days after a positive COVID-19 PCR test was 3.21 (95 % CI 2.75-3.74) compared to patients with other autoimmune diseases and the aOR was 5.34 (95 % CI 4.65-6.14) for patients with multiple sclerosis compared to all other individuals in the general population with a positive test. We found no increased risk of hospitalisations with COVID-19 in patients with multiple sclerosis using disease-modifying treatment 6 months prior to a positive COVID-19 PCR test compared to patients with multiple sclerosis without disease-modifying treatment (aOR 0.94 (95 % CI 0.69-1.27)).
Conclusions:
In this nationwide cohort of patients with multiple sclerosis, COVID-19 did not seem to trigger multiple sclerosis disease activity (based on proxy variables). We found a significantly increased risk of being hospitalised with COVID-19 in the first 30 days after a positive COVID-19 PCR test in patients with multiple sclerosis irrespective of the type of reference population. In patients with multiple sclerosis, the use of disease-modifying treatment did not increase the risk of hospitalisation with COVID-19.
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:18Factors Affecting Illness
For instance, risk factors are connected to illness,...
01:22Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...