The severity of COVID-19 and a lack of complete recovery are associated with new or worsening neurological symptoms in some patients with multiple sclerosis (MS) and related disorders, according to a new study published in Multiple Sclerosis and Related Disorders

This finding is important and suggests that these patients could be primary candidates for anti-SARS-CoV-2 monoclonal antibodies and other therapies, which can significantly decrease the risk of severe illness and hospitalizations due to the infection.

The effect of COVID-19 on patients with MS and related disorders is not well understood. Here, a team of researchers from Brigham and Women’s Hospital at Harvard Medical School in Boston, Massachusetts led by Maria K. Houtchens, MD, PhD, retrospectively analyzed the medical records of adult patients with MS or related disorders to clarify the effect of the infection on these patients.


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The researchers identified 111 such patients. They found that 41 of them (36.9%) had neurologic worsening after COVID-19 infection. Nineteen patients (46.3% of those with neurological worsening) had pseudorelapses, while 2 (4.8%) had relapses. Twenty-four patients reported either a worsening of their preexisting symptoms or new long-term neurologic symptoms.

Hospitalization due to COVID-19, COVID-19 treatment, and incomplete recovery from COVID-19 were all associated with neurologic worsening. On the other hand, neurological worsening was not associated with age, sex, race, type of MS, duration of disease, degree of disability, or the use of vitamin D or disease-modifying treatments.

MS is characterized by the immune system mistakenly attacking the myelin sheath surrounding nerve cells, leading to neurological symptoms. 

COVID-19 infection has also been associated with neurological symptoms including headache and loss of smell and taste, although the exact mechanism of this is not well understood.

Reference

Conway SE, Healy BC, Zurawski J, et al. COVID-19 severity is associated with worsened neurological outcomes in multiple sclerosis and related disorders. Mult Scler Relat Disord. Published online June 6, 2022. doi:10.1016/j.msard.2022.103946