Course Of Multiple Sclerosis Research Articles

Probiotics and Commensal Gut Microbiota as the Effective Alternative Therapy for Multiple Sclerosis Patients Treatment.

The gut-brain axis (GBA) refers to the multifactorial interactions between the intestine microflora and the nervous, immune, and endocrine systems, connecting brain activity and gut functions. Alterations of the GBA have been revealed in people with multiple sclerosis (MS), suggesting a potential role in disease pathogenesis and making it a promising therapeutic target. Whilst research in this field is still in its infancy, a number of studies revealed that MS patients are more likely to exhibit modified microbiota, altered levels of short-chain fatty acids, and enhanced intestinal permeability. Both clinical and preclinical trials in patients with MS and animal models revealed that the administration of probiotic bacteria might improve cognitive, motor, and mental behaviors by modulation of GBA molecular pathways. According to the newest data, supplementation with probiotics may be associated with slower disability progression, reduced depressive symptoms, and improvements in general health in patients with MS. Herein, we give an overview of how probiotics supplementation may have a beneficial effect on the course of MS and its animal model. Hence, interference with the composition of the MS patient's intestinal microbiota may, in the future, be a grip point for the development of diagnostic tools and personalized microbiota-based adjuvant therapy.

HLA-DRB1*1501 influences long-term disability progression and tissue damage on MRI in relapse-onset multiple sclerosis

Background: Whether genetic factors influence the long-term course of multiple sclerosis (MS) is unresolved. Objective: To determine the influence of HLA-DRB1*1501 on long-term disease course in a homogeneous cohort of clinically isolated syndrome (CIS) patients. Methods: One hundred seven patients underwent clinical and MRI assessment at the time of CIS and after 1, 3, 5 and 15 years. HLA-DRB1*1501 status was determined using Sanger sequencing and tagging of the rs3135388 polymorphism. Linear/Poisson mixed-effects models were used to investigate rates of change in EDSS and MRI measures based on HLA-DRB1*1501 status. Results: HLA-DRB1*1501 -positive (n = 52) patients showed a faster rate of disability worsening compared with the HLA-DRB1*1501 -negative (n = 55) patients (annualised change in EDSS 0.14/year vs. 0.08/year, p < 0.025), and a greater annualised change in T2 lesion volume (adjusted difference 0.45 mL/year, p < 0.025), a higher number of gadolinium-enhancing lesions, and a faster rate of brain (adjusted difference −0.12%/year, p < 0.05) and spinal cord atrophy (adjusted difference −0.22 mm2/year, p < 0.05). Interpretation: These findings provide evidence that the HLA-DRB1*1501 allele plays a role in MS severity, as measured by long-term disability worsening and a greater extent of inflammatory disease activity and tissue loss. HLA-DRB1*1501 may provide useful information when considering prognosis and treatment decisions in early relapse-onset MS.

Oligoclonal IgM bands are a promising biomarker for long-term cognitive outcomes in multiple sclerosis

BackgroundThe presence of lipid-specific oligoclonal IgM bands (LS-OCMB) in cerebrospinal fluid is associated with a more severe clinical multiple sclerosis (MS) course. ObjectiveTo investigate LS-OCMB as a prognostic biomarker of cognitive long-term outcomes in MS. MethodsNinety-nine patients underwent neuropsychological assessment. Cognitive performance between LS-OCMB– and LS-OCMB+ patients was compared adjusting by age, education, anxiety-depression, disease duration, and disability. ResultsLS-OCMB+ patients of ∼13 years of disease duration performed worse on Symbol Digit Modalities Test (SDMT) (p = 0.005). ConclusionLS-OCMB+ perform worse on information processing speed and working memory (SDMT), suggesting that LS-OCMB could be a useful biomarker for long-term cognitive outcomes.

Disease-modifying treatment patterns among multiple sclerosis patients: a Brazilian descriptive study

Introduction. Multiple sclerosis (MS) is an autoimmune disease that leads to demyelination of the central nervous system, compromising its functions. Although the course of MS is variable, it is a naturally progressive disease, which has accelerated neurological deterioration in most patients. Treatment pattern studies are important to understand the real-world practice and clinical outcomes. Objective. The aim of this study was to describe treatment patterns among patients with MS in the Brazilian public healthcare system. Method. A retrospective cohort study was carried out through the analysis of secondary data from 2008 to 2020. To compare the clinical practice with that recommended by the Clinical Protocols and Therapeutic Guidelines (PCDT) over the years, the treatment analyzes were fragmented into 2008-2014, 2015-2017, and 2018-2020. The data was obtained from Brazilian National Health System, which is a real-world anonymized database. Results. MS patients were identified by the G35 code on International Classification of the Diseases 10th edition and with code 340 on 9th edition. The incidence and prevalence rates were calculated by years, in 2020 the incidence rate was 1.7 per 100,000 population. Conclusions. Regarding the treatment patterns, beta-interferon was the most common first-line prescribed medication for MS in all the three analyzed periods, followed by glatiramer acetate. Glatiramer was the most frequently prescribed second-line treatment only in the first extracted period (2008–2014).

Multiple Sclerosis and Autoimmune Comorbidities

Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system characterized by broad inter- and intraindividual heterogeneity and different prognoses. Multisystem comorbidities are frequent features in people with MS (PwMS) and can affect treatment choices, quality of life, disability and mortality. In this scenario, autoimmune comorbidities play a cardinal role for several reasons, such as the implication on MS pathogenesis, diagnostic delay, disease activity, disability progression, brain atrophy, and treatment choice. However, the impact of an autoimmune comorbid condition on MS is not fully elucidated. This review aims to summarize the currently available data on the incidence and prevalence of autoimmune diseases in PwMS, the possible effect of this association on clinical and neuroradiological MS course and its impact on treatment choice.

Efficacy, safety and tolerability of dimethylfumarate during pregnancy and breastfeeding

<h3>Background</h3> The disease course in relapsing-remitting multiple sclerosis (RRMS) is notably affected by pregnancy. Disease-modifying therapies are usually contraindicated during pregnancy and breastfeeding for safety reasons. We assessed safety and tolerability of dimethylfumarate (DMF) in women with RRMS and their infants. <h3>Methods</h3> We observed 29 pregnancies of 26 women, followed from 2015 to 2020. DMF was administered through week 24 of pregnancy and resumed one month after delivery. We followed mothers with clinical follow-up, MRI and regular ultrasounds to establish the safety and efficacy of DMF during pregnancy and lactation. Infants were monitored up to the third year for infections and developmental disorders. <h3>Results</h3> No voluntary terminations, ectopic pregnancies, miscarriages or congenital abnormalities were detected. 3 infants (10%) were born preterm. 26 and 3 newborns had an 8/8 and a 7/8 biophysical profile (BPP) score, respectively. During growth, all children resulted between the 70^th and 95^th percentile for height and weight. Only 1 serious infection was detected in a child. 22/26 mothers decided to breastfeed (interval: 4–7 months). No relapses were observed during pregnancy and during the first 6 months post-delivery. 2 relapses were observed in the 6–12-month interval. New T2 lesions were detected in 3/26 scans at 3 months, 2/26 scans at 12 months, 3/24 scans at 24 months. <h3>Conclusion</h3> All outcomes related to infant birth and development were comparable to the general population, despite DMF intake during pregnancy. DMF effectively prevented increased disease activity during puerperium. According to our data, continuing therapy while breastfeeding is also safe. <h3>Keywords</h3> Pregnancy, Breastfeeding, Case series, Dimethylfumarate, Safety, Magnetic resonance imaging <h3>Disclosures</h3> AI has received consulting fees from Janssen. GB has no conflict of interest or other disclosures to report.

Multiple sclerosis in children

This article deals with the clinical features of the course of multiple sclerosis in children. The indices and peculiarities of the disease variations are important characteristic criteria of the general state of health and quality of life in children and adults. The evaluation was carried out on the basis of the data of multiple studies worldwide, which allowed us to draw conclusions on the peculiarities of the course of multiple sclerosis in children and the possibilities of therapeutic approaches for the correction o tfheir state.

Characteristics and management of multiple sclerosis patients during the Omicron era: is there a concern about the MS course in the face of the new variant of COVID-19?

IntroductionThe Omicron variant of COVID-19 is highly transmissible, triggering unprecedented infection rates. The present study aimed to investigate the course of multiple sclerosis (MS) in the Omicron era among Iranian patients with MS. MethodsThis observational study was designed on MS patients of the national MS registry of Iran through a self-designed online questionnaire. A questionnaire was prepared as a Google Form for MS patients during the Omicron outbreak from 1 March to 30 April 2022.ResultsOne hundred seventy-four patients with a mean age of 37.3 ± 9.04 were enrolled. Of the patients, 95.97% used DMT, the most common of which were rituximab and fingolimod. Of the patients, 77.58% were fully vaccinated for COVID-19. Regardless of the COVID-19 vaccination status, 76 patients developed COVID-19, which was mild to moderate. Except for recent corticosteroid therapy and secondary progressive MS (SPMS), other demographic and MS characteristics were not significantly associated with the severity of COVID-19. There was also a marginal association between the Expanded Disability Status Scale (EDSS) and the severity of COVID-19. In addition, 17.10% of patients reported MS relapse following COVID-19 leading to escalation therapy in eight patients.ConclusionOur study demonstrated that in the Omicron era, most patients developed mild COVID-19. Although the predominant COVID-19 variant in this period was Omicron, we could not separate the pathogenic variants. The risk factors for COVID-19 during the Omicron era were not different from other pandemic waves. Our preliminary results revealed that the MS relapse following COVID-19 was higher than in previous waves.

Pregnancy in the context of Multiple Sclerosis

Multiple Sclerosis is a chronic autoimmune neurodegenerative disorder which affects brain, spinal cord and optic nerve. During last years the perception over the disease changed dramatically, now being considered a handleable disease. The particularity of this subject is that Multiple Sclerosis is a disease which affects mostly young women, many of them not having any children at the moment of diagnosis. This article highlights the fact that women diagnosed with Multiple Sclerosis are allowed to get pregnant, and, moreover, they are encouraged to live a normal life. In most cases, disease activity freezes during pregnancy, only a small percentage of women will continue to have clinically and radiologically active disease. For those women, IFN-β and Glatiramer Acetate are the first-choice therapies that should be given. In cases when the disease is not responding to common medication, refractory to treatment forms may be successfully treated with Natalizuab, during the first and the second trimester. Breastfeeding is also encouraged, as it has a protective effect on disease progression. The main purpose of this article is to make a literature review in which to summarize the updates regarding pregnancy and postpartum management, relapses management and, also, the impact of pregnancy on Multiple Sclerosis course. The analysis was limited to articles written in English and published between August 2019 - October 2022 on PubMed, NCBI and Medical Journals.

The role of constitutional features of body structure in the occurrence and course of multiple sclerosis (literature review)

Annotation. The widespread prevalence of multiple sclerosis in different parts of the world among representatives of different races, nationalities, age groups, gender groups, chronic course of disease, the high cost of treatment and a significant percentage of disability of the working population makes this disease more relevant for scientific research than ever. One of the understudied aspects of domestic scientists is the anthropometric indicators іn group of patients suffering from multiple sclerosis. The aim of the study is to conduct a review a literary sources for the period 2012-2022, related to the topic of the human constitution and multiple sclerosis. A study of 29 sources that met the inclusion criteria was carried out. For the most part, the following anthropometric indicators were found in the publications, which had one or another reliable connection with the risk of occurrence or the course of multiple sclerosis: body mass index, ratio of muscles and fat in the body, waist circumference. Also important factors that were pay attention to account by the researchers and as a result in addition influenced the results of the research were: nationality, race, age and sex. According to the data of the analyzed studies, body mass index has the greatest contribution to the rate of disease progression between the studied groups with different course of multiple sclerosis, while sex had a greater influence on the occurrence of a certain specific type of course of multiple sclerosis. Accordingly to the analysis of literary sources revealed that there is a need to conduct an anthropometric study of Ukrainians suffering from multiple sclerosis in order to further form groups of key indicators that can be used to predict the risk of occurrence and course of this disease. This will become possible due to conducting a clinical and anthropological study that will be carried out in the future.

Using personalized prognosis in the treatment of relapsing multiple sclerosis: A practical guide.

The clinical course of multiple sclerosis (MS) is highly variable among patients, thus creating important challenges for the neurologist to appropriately treat and monitor patient progress. Despite some patients having apparently similar symptom severity at MS disease onset, their prognoses may differ greatly. To this end, we believe that a proactive disposition on the part of the neurologist to identify prognostic “red flags” early in the disease course can lead to much better long-term outcomes for the patient in terms of reduced disability and improved quality of life. Here, we present a prognosis tool in the form of a checklist of clinical, imaging and biomarker parameters which, based on consensus in the literature and on our own clinical experiences, we have established to be associated with poorer or improved clinical outcomes. The neurologist is encouraged to use this tool to identify the presence or absence of specific variables in individual patients at disease onset and thereby implement sufficiently effective treatment strategies that appropriately address the likely prognosis for each patient.

Prognostic impact of epileptic seizures in multiple sclerosis varies according to time of occurrence and etiology.

Epileptic seizures occur more often in patients with multiple sclerosis (MS) than in the general population. Their association with the prognosis of MS remains unclear. This study was undertaken to evaluate whether epileptic seizures may be a prognostic marker of MS disability, according to when the seizure occurs and its cause. Data were extracted from a population-based registry of MS in Lorraine, France. Kaplan-Meier curves and log-rank tests were used to compare the probability of different levels of irreversible handicap during the course of MS in patients who experience epileptic seizures or do not, according to the chronology and the cause of the first epileptic seizure. Among 6238 patients, 134 had experienced at least one epileptic seizure (2.1%), and 82 (1.2%) had seizures secondary to MS. Patients with epileptic seizure as a first symptom of MS (14 patients) had the same disease progression as other relapsing-remitting MS patients. Patients who developed epileptic seizures during the course of MS (68 patients) had a higher probability of reaching Expanded Disability Status Scale=3.0 (p= 0.006), 6.0 (p= 0.003), and 7.0 (p= 0.004) than patients without an epileptic background. Patients with a history of epileptic seizures unrelated to MS also had a worse prognosis than patients without an epileptic background. Epileptic seizures might be viewed as a "classic MS relapse" in terms of prognosis if occurring early in MS, or as a marker of MS severity if developing during the disease. Epileptic diseases other than MS may worsen the course of MS.

The Rate of Hospitalization of Pregnant Women with Multiple Sclerosis in Poland.

Multiple sclerosis (MS) is most often diagnosed in women of childbearing age. Therefore, it is important to examine the impact of pregnancy on the course of MS and to enable patients to make decisions about motherhood based on reliable data. The main objective of this study was to assess the impact of pregnancy on the course of MS by comparing the frequency of MS-related hospitalizations during pregnancy and 40 weeks postpartum versus 40 weeks before pregnancy. We used administrative health claims to identify female patients with MS, their deliveries, and their MS-related hospital admissions and calculated the frequency of MS-related hospital admissions before, during, and after pregnancy. We observed that MS is diagnosed approximately three times less often during pregnancy than before or after pregnancy. The number of MS-related hospital admissions decreased during pregnancy, especially in the third trimester. In contrast with other studies, we did not observe an increased level of MS-related admissions postpartum. The number of hospitalizations reported with steroid injections and emergency department visits also decreased during pregnancy. Our results show that pregnancy has a protective effect on the course of MS.

Th17-cells in depression: Implication in multiple sclerosis.

Depression is one of the most common neuropsychological symptoms of multiple sclerosis. However, in addition to mood disorder, depression can also influence on multiple sclerosis course. The mechanism of this dependence is not fully understood. The recent studies suggest the possible common immune mechanisms in the pathogenesis of depression and multiple sclerosis. In particular, it was shown that along with biogenic amines disturbance, neuroinflammation also play an important role in the pathogenesis of depression. Significant attention is drawn to Th17-cells subsets, which are considered as critical players in the pathogenesis of inflammatory diseases of the central nervous system, including multiple sclerosis. This brief report reviews the literature data on the role of neuroinflammation in the reciprocal influence of multiple sclerosis and depression with focus on Th17-cells, which may underlie pathogenetic mechanisms of both this diseases.

Vaccination willingness in association with personality traits in patients with multiple sclerosis in the course of SARS-CoV-2 pandemic

Vaccination is a key strategy for controlling the SARS-CoV-2 pandemic. Acceptance of SARS-CoV-2 vaccines by chronically ill patients, such as multiple sclerosis (MS) patients, plays an important role in prevention of complicated disease course. This longitudinal, prospective, multi-centre-study of German MS-patients aimed to detect socio-demographic, clinical, or psychological determinants of attitudes towards standard vaccines, SARS-CoV-2 vaccines, and governmental measures before/during the pandemic. Exactly 404 MS-patients were investigated by standardized questionnaires and structured interviews on socio-demographic, clinical-neurological, and psychological characteristics, vaccination status, and vaccination from June 2019. Data on SARS-CoV-2 vaccination willingness were collected in two follow-up assessments (1st: June to July 2020, before SARS-CoV-2 vaccine availability, N = 200; 2nd: March to May 2021, after SARS-CoV-2 vaccine availability, N = 157). Age, sex, MS course type, depression, and personality characteristics (Extraversion, Novelty seeking, Self-directedness, and Cooperativeness) were significantly associated with vaccination willingness. Although the majority of MS-patients showed SARS-CoV-2 vaccination willingness at both follow-ups (1st: 60%, 2nd: 61%), a substantial proportion had concerns and were undecided or opposed to vaccination. Socio-demographic variables like age and sex, psychopathological status, and various personality characteristics might influence vaccination willingness and should be considered when discussing with MS-patients about SARS-CoV-2 vaccination.

Clinical and epidemiological features of multiple sclerosis in Republic of Ingushetia

Objective: to study clinical and epidemiological features and risk factors in patients with multiple sclerosis (MS) living in Rostov region and Republic of Ingushetia (RI)Materials and methods: we examined 87 patients with definite multiple sclerosis. We evaluated neurological deficiency and the specificity of MS course. We have also studied serum concentration of vitamin D3 metabolite — 25(ОН)D3 by ELISA method.Results: the prevalence of NS in RI was 16,9 cases for 100 thousand of the population as of 1.01.2022. Risk fаctors of MS dеvеlopment were cоntаct with pеtrоl, оil prоducts аnd pаints аt аgу оvуr 15 yеаrs оld, cоntаct with аnimаls аt аgе bеfоrе 15 yеаrs оld, a surgicаl intеrvеntiоn, sеvеrе cаriеs аt аgе оvеr 15 yеаrs оld, heаd injury at аny аgе, tоnsillitis, meаslеs, rubеllа оccurrеd аt аgе bеfоrе 7 yеаrs оld аnd hеrpеtic infеctiоn аt аny аgе, thе diffеrеncеs wеrе stаtisticаlly signifiаant. In fеmаlе MS pаtiеnts wе оbsеrvеd highеr pаrаmеtеrs of rеlаpsе frеquеncy аnd MS prоgrеssiоn sрееd, the diffеrеnсеs wеrе stаtisticаlly significаnt. Ассоrding tо thе cоmpаrisоn оf sеrum vitаmin D cоncеntrаtion wе rеvеаlеd a stаtisticаlly rеliаblе dеcrеasе of sеrum vitamin D lеvеl in male MS patients living in RI compared to the control group.Conclusions: the regions of Republic of Ingushetia belong to the areas with low and medium multiple sclerosis development risk. The external factors of MS development risk confirm the multifactor nature of the disease. The decrease of serum vitamin D concentration is one of the main modifiable MS risk factors.

The use of functional near infrared spectroscopy and gait analysis to characterize cognitive and motor processing in early-stage patients with multiple sclerosis.

BackgroundDual-task paradigms are a known tool to evaluate possible impairments in the motor and cognitive function in patients with multiple sclerosis (MS). A technique to evaluate the cortical function during movement is functional near-infrared spectroscopy (fNIRS). The evaluation of the MS course or its treatment by associating fNIRS with gait measurements may be flexible and low-cost; however, there are no feasibility studies in the literature using these combined techniques in early-stage patients with MS.ObjectiveTo evaluate cortical hemodynamics using fNIRS and gait parameters in patients at early stages of MS and in healthy controls during a dual-task paradigm.MethodsParticipants performed cognitive tasks while walking to simulate daily activities. Cortical activation maps and gait variability were used to evaluate differences between 19 healthy controls and 20 patients with MS.Results and conclusionThe results suggest an enhanced cortical activation in the motor planning areas already at the early stages of MS when compared to controls. We have also shown that a systematic analysis of the spatiotemporal gait variability parameters indicates differences in the patient population. The association of cortical and gait parameters may reveal possible compensatory mechanisms related to gait during dual tasking at the early stages of the disease.

Fatigue in Multiple Sclerosis Is Associated with Reduced Expression of Interleukin-10 and Worse Prospective Disease Activity.

In multiple sclerosis (MS), fatigue is a frequent symptom that negatively affects quality of life. The pathogenesis of fatigue is multifactorial and inflammation may play a specific role. To explore the association between fatigue, central inflammation and disease course in MS in 106 relapsing-remitting (RR)-MS patients, clinical characteristics, including fatigue and mood, were explored at the time of diagnosis. NEDA (no evidence of disease activity)-3 status after one-year follow up was calculated. Cerebrospinal fluid (CSF) levels of a set of proinflammatory and anti-inflammatory molecules and peripheral blood markers of inflammation were also analyzed. MRI structural measures were explored in 35 patients. A significant negative correlation was found at diagnosis between fatigue measured with the Modified Fatigue Impact Scale (MFIS) and the CSF levels of interleukin (IL)-10. Conversely, no significant associations were found with peripheral markers of inflammation. Higher MFIS scores were associated with reduced probability to reach NEDA-3 status after 1-year follow up. Finally, T2 lesion load showed a positive correlation with MFIS scores and a negative correlation with CSF IL-10 levels at diagnosis. CSF inflammation, and particularly the reduced expression of the anti-inflammatory molecule IL-10, may exacerbate fatigue. Fatigue in MS may reflect subclinical CSF inflammation, predisposing to greater disease activity.

Deconvolution of B cell receptor repertoire in multiple sclerosis patients revealed a delay in tBreg maturation.

BackgroundB lymphocytes play a pivotal regulatory role in the development of the immune response. It was previously shown that deficiency in B regulatory cells (Bregs) or a decrease in their anti-inflammatory activity can lead to immunological dysfunctions. However, the exact mechanisms of Bregs development and functioning are only partially resolved. For instance, only a little is known about the structure of their B cell receptor (BCR) repertoires in autoimmune disorders, including multiple sclerosis (MS), a severe neuroinflammatory disease with a yet unknown etiology. Here, we elucidate specific properties of B regulatory cells in MS.MethodsWe performed a prospective study of the transitional Breg (tBreg) subpopulations with the CD19+CD24highCD38high phenotype from MS patients and healthy donors by (i) measuring their content during two diverging courses of relapsing-remitting MS: benign multiple sclerosis (BMS) and highly active multiple sclerosis (HAMS); (ii) analyzing BCR repertoires of circulating B cells by high-throughput sequencing; and (iii) measuring the percentage of CD27+ cells in tBregs.ResultsThe tBregs from HAMS patients carry the heavy chain with a lower amount of hypermutations than tBregs from healthy donors. The percentage of transitional CD24highCD38high B cells is elevated, whereas the frequency of differentiated CD27+ cells in this transitional B cell subset was decreased in the MS patients as compared with healthy donors.ConclusionsImpaired maturation of regulatory B cells is associated with MS progression.

COVID-19 and its implications on the clinico-radiological course of multiple sclerosis: A case-control study.

Antecedentes: la esclerosis múltiple (EM) es una enfermedad inmunomediada que se ha relacionado con varios factores de riesgo, como diversas infecciones virales. Realizamos este estudio para establecer una relación entre la infección por COVID-19 y la gravedad de la EM.Métodos: En un estudio de casos y controles, reclutamos pacientes con esclerosis múltiple remitente-recurrente (EMRR). Los pacientes se dividieron en dos grupos según la PCR positiva para COVID-19 al final de la fase de inscripción. Cada paciente fue seguido prospectivamente durante 12 meses. Los antecedentes demográficos, clínicos y médicos anteriores se recogieron durante la práctica clínica habitual. Las evaluaciones se realizaron cada seis meses; La resonancia magnética se realizó en el momento de la inscripción y 12 meses después.Resultados: Trescientos sesenta y dos pacientes participaron en este estudio. Los pacientes con EM con infección por COVID-19 tuvieron aumentos significativamente más altos en el número de lesiones de resonancia magnética (p: 0.019, OR (IC): 6.37 (1.54-26.34)) y puntajes EDSS (p: 0.017), pero no se encontraron diferencias en total recaídas anuales o tasas de recaída. Las infecciones por COVID-19 se correlacionaron positivamente con la progresión de EDSS (p: 0,02) y la cantidad de nuevas lesiones en la resonancia magnética (p: 0,004) y predijeron la probabilidad de la cantidad de nuevas lesiones en la resonancia magnética con una probabilidad de 5,92 (p: 0,018).Conclusión: COVID-19 puede conducir a puntajes de discapacidad más altos en la población de RRMS y está asociado con el desarrollo de nuevas lesiones realzadas con Gd en imágenes de resonancia magnética. Sin embargo, no se observó diferencia entre los grupos en cuanto al número de recaídas durante el seguimiento.