The influence of COVID infection on the course of multiple sclerosis

Abstract

Objective — to analyse the clinical picture and course of multiple sclerosis (MS) in the context of coronavirus disease-2019 (COVID-19) using neurofunctional scales. Materials and methods. A prospective and retrospective hybrid single-centre cohort study of 34 patients with MS who had suffered from COVID-19 was conducted. The diagnosis of MS was made using the international criteria of McDonald et al. (2017) The neurological deficit and disability level of patients with MS was assessed using the Expanded Disability Status Scale (EDSS). The comprehensive functional examination of patients with MS included the following neurofunctional tests: Timed 25-Foot Walk (T25FW), 9 Hole Peg Test (9HPT) and Symbol Digit Modalities Test (SDMT). Results. The mean annual deterioration of EDSS in the post-COVID period was (0.5 ± 0.9) points (p < 0.05), in the pre-COVID period — only (0.1 ± 0.8) points (p > 0.05). An increase in the EDSS score was associated with a negative dynamics of the T25FWT test score in the post-lesion period (respectively 1.8 ± 28.2 and 4.7 ± 12.5; p < 0.05). The scores of the 9HPT and SDMT neurofunctional tests did not undergo significant changes during the study periods. In the post-COVID period, there was also an increase in the frequency of exacerbations by 8.8 % and signs of MS progression in 5.9 % of cases. Conclusions. The effect of SARS-CoV-2 virus on the development of exacerbations and progression of MS requires long-term studies in larger cohorts of patients. Due to the triggering effect of coronavirus infection on the immune system and the activation of demyelinating diseases of the nervous system, epidemiological measures should be strengthened in this cohort of patients. The course of MS in the setting of COVID-19 may depend on the availability, type, and adherence to disease-modifying therapy.