To understand the impact of COVID-19 on the disease activities of multiple sclerosis.

COVID-19 pandemic is thought to influence the natural history of immune disorders, but its effect on multiple sclerosis (MS) is not fully understood

We studied all patients with MS seen in our hospital between March 2020 and August 20201. We identified patients infected with COVID-19, who had 4 at least 4-6 months follow up afterwards. We determined clinical and radiological evidence of disease activities in all patients by the end of the study period.

We studied 301 patients; 216 (72 %) were women, the mean age was 38 years (range; 16, 73 years), and the mean disease duration was 10 years (range; 1, 36 years). The median EDSS score was 0.5 (range; 0, 8). RRMS accounted for most of cases (270 patients). Thirty (10 %) patients were infected with COVID-19 (table 1). All patients reported mild symptoms, and none required hospitalization. None of our patients were fully vaccinated during the study. COVID-19 was prevalent among younger patients with RRMS, who were mobilizing, irrespective of DMTs they received (figure 1). Twenty-five patients had clinical relapses, but only one patient had COVID-19 preceding the relapse. Similarly, 73 patients had MRI disease activities, 8 of those had COVID-19 positive PCR prior to MRI changes. Disease activities were dependent on DMT use, but not COVID-19 status (figure 2 and 3). The later observation was also supported by multiple logistic regression analyses (adjusted odds ratio for MRI and clinical changes were 1.39 and 0.35 respectively, p = 0.4 and 0.3 respectively).

Despite its high prevalence in our patients, COVID-19 didn’t appear to influence the disease activities in our patients with MS. Standard precautions to reduce the risk of COVID-19 transmission must be applied, particularly in young patients with minimal or no disabilities.