Abstract
Background
COVID-19 is speculated to increase the likelihood of relapsing-remitting multiple sclerosis (RRMS) exacerbation.
Objective
To investigate the association between contraction of COVID-19 and incidence of acute MS attacks in RRMS patients six months post-infection.
Methods
This retrospective cohort study compares the risk of relapse in RRMS patients with (n=56) and without COVID-19 (n=69). Incidence of relapse was recorded for six-month following contraction of COVID-19. Incidence of RRMS exacerbation in patients with COVID-19 was compared to patients without COVID-19 (the independent control group) and the same patients six months prior to the COVID-19 pandemic.
Results
A lower incidence rate of RRMS exacerbation was observed in patients that contracted COVID-19 than in patients who did not contract COVID-19 (incidence rate ratio: 0.275; p=0.026). Self-controlled analysis showed no significant difference in relapse rates before the COVID-19 pandemic and after contracting COVID-19 (p=0.222). The relapse risk was not different between patients who had been hospitalized due to COVID-19 severity and those who had not (p=0.710).
Conclusion
COVID-19 contraction may not increase the risk of acute MS attacks shortly following contraction. We hypothesize that COVID-19-associated lymphopenia may partly preclude the autoreactive memory cells from expansion and initiating relapses through a so-called bystander effect of COVID-19 infection.
【저자키워드】 COVID-19, SARS-CoV-2, multiple sclerosis, Relapsing-Remitting Multiple Sclerosis, 【초록키워드】 Hospitalized, COVID-19 pandemic, COVID-19 severity, risk, lymphopenia, COVID-19 infection, Patient, incidence rate, incidence, association, Analysis, memory cell, retrospective cohort study, bystander, Post-infection, control group, no significant difference, attack, objective, likelihood, independent, Result, not different, patients with COVID-19, patients without COVID-19, was recorded, 【제목키워드】 Relapse, Multiple, sclerosis,