Afagh Garjani1, Rodden M Middleton2, Rachael Hunter3, Katherine A Tuite-Dalton2, Alasdair Coles4, Ruth Dobson5, Martin Duddy6, Stella Hughes7, Owen R Pearson8, David Rog9, Emma C Tallantyre10, Roshan das Nair11, Richard Nicholas12, Nikos Evangelou13. 1. Mental Health and Clinical Neuroscience Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK; Clinical Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK. 2. Population Data Science, Swansea University Medical School, Swansea, UK. 3. College of Health and Human Science, Swansea University, Swansea, UK. 4. Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK. 5. Preventive Neurology Unit, Queen Mary University London, London, UK. 6. Neurosciences, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK. 7. Department of Neurology, Belfast Health and Social Care Trust, Belfast, UK. 8. Neurology Department, Swansea Bay University Health Board, Swansea, UK. 9. Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK. 10. Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, UK. 11. Mental Health and Clinical Neuroscience Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK; Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK. 12. Department of Cellular and Molecular Neuroscience, Imperial College London, London, UK. 13. Mental Health and Clinical Neuroscience Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK; Clinical Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK. Electronic address: nikos.evangelou@nottingham.ac.uk.
Abstract
BACKGROUND: Infections can trigger exacerbations of multiple sclerosis (MS). The effects of the coronavirus disease 2019 (COVID-19) on MS are not known. The aim of this study was to understand the impact of COVID-19 on new and pre-existing symptoms of MS. METHODS: The COVID-19 and MS study is an ongoing community-based, prospective cohort study conducted as part of the United Kingdom MS Register. People with MS and COVID-19 were invited by email to complete a questionnaire about their MS symptoms during the infection. An MS exacerbation was defined as developing new MS symptoms and/or worsening of pre-existing MS symptoms. RESULTS: Fifty-seven percent (230/404) of participants had an MS exacerbation during their infection; 82 developed new MS symptoms, 207 experienced worsened pre-existing MS symptoms, and 59 reported both. Disease modifying therapies (DMTs) reduced the likelihood of developing new MS symptoms during the infection (OR 0.556, 95%CI 0.316-0.978). Participants with a higher pre-COVID-19 webEDSS (web-based Expanded Disability Status Scale) score (OR 1.251, 95%CI 1.060-1.478) and longer MS duration (OR 1.042, 95%CI 1.009-1.076) were more likely to experience worsening of their pre-existing MS symptoms during the infection. CONCLUSION: COVID-19 infection was associated with exacerbation of MS. DMTs reduced the chance of developing new MS symptoms during the infection. Crown
BACKGROUND: Infections can trigger exacerbations of multiple sclerosis (MS). The effects of the coronavirus disease 2019 (COVID-19) on MS are not known. The aim of this study was to understand the impact of COVID-19 on new and pre-existing symptoms of MS. METHODS: The COVID-19 and MS study is an ongoing community-based, prospective cohort study conducted as part of the United Kingdom MS Register. People with MS and COVID-19 were invited by email to complete a questionnaire about their MS symptoms during the infection. An MS exacerbation was defined as developing new MS symptoms and/or worsening of pre-existing MS symptoms. RESULTS: Fifty-seven percent (230/404) of participants had an MS exacerbation during their infection; 82 developed new MS symptoms, 207 experienced worsened pre-existing MS symptoms, and 59 reported both. Disease modifying therapies (DMTs) reduced the likelihood of developing new MS symptoms during the infection (OR 0.556, 95%CI 0.316-0.978). Participants with a higher pre-COVID-19 webEDSS (web-based Expanded Disability Status Scale) score (OR 1.251, 95%CI 1.060-1.478) and longer MS duration (OR 1.042, 95%CI 1.009-1.076) were more likely to experience worsening of their pre-existing MS symptoms during the infection. CONCLUSION: COVID-19 infection was associated with exacerbation of MS. DMTs reduced the chance of developing new MS symptoms during the infection. Crown
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