A new study on people with multiple sclerosis (MS) shows that their risk for severe COVID-19 is determined primarily by age, disability, and comorbidities, and vaccination protects against severe disease.

The study, published in the European Journal of Neurology, noted that anti-CD20 treatment was associated with a moderately increased risk of severe COVID-19, but other treatments were not.

“There is robust evidence that the risk for severe COVID-19 in [patients with MS] is—similar to the general population—primarily determined by age and comorbidities,” the authors wrote. “However, data on the impact of SARS-CoV-2 vaccines on the clinical severity of COVID-19 in [patients with MS] are currently very scarce.“

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“The objective of this study was to reevaluate predictors of COVID-19 outcome in [patients with MS] in a nationwide population-based study, specifically focusing on the impact of vaccination,” the authors explained.

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The authors analyzed data from 317 patients with MS from the Austrian MS-COVID-19 registry between January 1, 2020, and February 28, 2022. Patients were classified based on their a priori COVID-19 severity risk considering age, disability (as measured by the Expanded Disability Status Scale), obesity, smoking status, and various additional comorbidities. The outcome measure was severe COVID-19 requiring hospitalization and intensive care. Vaccination status was also recorded.

The analysis revealed that: 1) the severity of COVID-19 infection was determined primarily by the patients’ a priori risk, 2) patients on anti-CD20 treatment had a moderately increased risk of severe COVID-19 but other treatments did not increase this risk, and 3) fully vaccinated patients with MS were 5 times less likely to have severe COVID-19 than unvaccinated patients.

The authors recommend full vaccination for all patients with MS, after which clinicians can focus therapy decisions on treating MS rather than on the risk of COVID-19.


Bsteh G, Gradl,C, Heschl B, et al; AUT-MuSC investigators. Impact of vaccination on COVID-19 outcome in multiple sclerosis. Eur J Neurol. Published online July 5, 2022. doi:10.1111/ene.15488