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Incidence of multiple sclerosis (MS) relapse after COVID-19 infection: A systematic review and meta-analysis

Amin Momeni Moghaddam1, Mohsen Rastkar2, Atena Soltanzadi1

  • 1Department of Radiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Caspian Journal of Internal Medicine
|July 11, 2025
PubMed
Abstract

Insights

COVID-19 can worsen multiple sclerosis (MS) symptoms. This review found a 7% pooled incidence of MS relapse after COVID-19 infection, highlighting the need for careful monitoring in these patients.

Area of Science:

  • Neurology
  • Immunology
  • Infectious Diseases

Background:

  • COVID-19 is known to potentially exacerbate autoimmune conditions.
  • Existing literature indicates an increased risk of relapse in multiple sclerosis (MS) patients post-COVID-19 infection.

Purpose of the Study:

  • To estimate the pooled incidence of multiple sclerosis (MS) relapse following COVID-19 infection.
  • To synthesize current evidence on the impact of COVID-19 on MS disease activity.

Main Methods:

  • A systematic review and meta-analysis was conducted.
  • Searches were performed across major databases (PubMed, Scopus, EMBASE, Web of Science, Google Scholar) and gray literature.
  • Data from 12 studies involving 1595 MS patients with a history of COVID-19 were analyzed.

Main Results:

  • The pooled incidence of MS relapse after COVID-19 was calculated to be 7% (95% CI: 5-10%).
  • Relapse incidence varied between 2% and 20% across the included studies.
  • The analysis included data from studies primarily conducted in Iran, with patient ages ranging from 35-49 years.

Conclusions:

  • COVID-19 infection is associated with a 7% pooled incidence of relapse in patients with multiple sclerosis.
  • These findings underscore the importance of monitoring MS patients for disease activity after SARS-CoV-2 infection.
Keywords:
COVID-19IncidenceMultiple sclerosisRelapse

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