Neurological sequela of COVID-19 in adults with multiple sclerosis

Possible interactions in neuropsychiatric presentations of multiple sclerosis (MS) and COVID-19 may occur, which has been proposed in previous, albeit limited, literature.

Examine COVID-19 disease outcomes and changes in neuropsychiatric symptoms among patients with MS.

A retrospective cohort study using electronic medical records from the National COVID Cohort Collaborative (N3C) database was conducted. 26,963 adults with MS diagnosed with COVID-19 were included in the study, and propensity score matched to 80,889 neurologically healthy adults with COVID-19. Group differences in risk for general COVID-19 disease outcomes, 15 acute COVID-19-associated neuropsychiatric complications, and 6 chronic MS-associated neuropsychiatric symptoms were assessed.

Patients with MS were at a higher risk for mortality; hospitalization; long-COVID diagnosis; more severe COVID-19 disease; 9 of the 15 acute complications, including cognitive impairment (OR: 4.059, p < 0.001), neuralgia (OR: 3.961, p < 0.001), dysautonomia (OR: 2.740, p < 0.008), and paresthesia (OR: 2.522, p < 0.001); and 5 of the 6 chronic symptoms, including cognitive impairment (OR: 2.945, p < 0.001), fatigue (OR: 2.190, p < 0.001), and depression (OR: 1.345, p < 0.001).

Patients with MS are at risk for adverse COVID-19 outcomes. This warrants heightened caution in this population when managing COVID-19 infections.