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Updated: Sep 20, 2025

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SARS-CoV-2 Is Linked to Brain Volume Loss in Multiple Sclerosis

Tomas Uher1, Dominika Stastna1, Ingrid Menkyova1,2

  • 1Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czechia.

Annals of Clinical and Translational Neurology
|May 30, 2025
PubMed
Abstract

Insights

SARS-CoV-2 infection increased brain and spinal cord tissue loss in patients with multiple sclerosis (pwMS), particularly in those over 40. This study highlights potential long-term neurological effects of COVID-19 in pwMS.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neuroimmunology

Background:

  • The neurological impact of SARS-CoV-2 infection on patients with multiple sclerosis (pwMS) is not well understood.
  • Investigating changes in brain and spinal cord pathology post-SARS-CoV-2 is crucial for managing pwMS.

Purpose of the Study:

  • To assess the effects of SARS-CoV-2 infection on brain lesion activity and volumes in pwMS.
  • To evaluate changes in spinal cord volume following SARS-CoV-2 infection in pwMS.

Main Methods:

  • 177 pwMS with confirmed SARS-CoV-2 infection underwent MRI scans.
  • Analysis focused on brain lesion load and brain/spinal cord volumes using mixed-effect models.
  • Patients were clinically stable, without disease activity or recent treatment changes.

Main Results:

  • SARS-CoV-2 infection did not alter brain lesion count or volume.
  • Significant whole brain, grey matter, and cortical grey matter volume loss was observed.
  • Ventricular enlargement occurred in pwMS over 40; reduced cervical cord area was seen in severe infections.

Conclusions:

  • SARS-CoV-2 infection is associated with increased neuronal tissue loss in clinically stable pwMS.
  • Age influences the extent of brain volume changes post-SARS-CoV-2.
  • Severity of SARS-CoV-2 infection correlates with spinal cord volume reduction.
Keywords:
COVID‐19MRISARS‐CoV‐2brain atrophybrain lesionmultiple sclerosis

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