Distinct Clinical Manifestations of COVID-19 in Multiple Sclerosis Patients: Unraveling the Clinical Nexus

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is a virus in the coronaviridae, has caused a global pandemic with various symptoms and complications. Among the groups affected by this virus are individuals with multiple sclerosis (MS), a chronic autoimmune disorder that affects the primary central nervous system (CNS). Understanding coronavirus disease 2019’s (COVID-19) impact on MS patients is crucial for optimizing patient management and developing targeted therapies due to the challenges it presents. Objectives: The primary purpose of this study was to investigate the respiratory and neurology symptoms of COVID-19 in patients with MS in comparison to the non-infected group. Furthermore, this study examined how age and gender might affect the symptoms of contracting COVID-19 and the mortality rate in patients with MS. Methods: The data were collected from six hospitals within the Iranian Network for Research in Viral Diseases (INRVD) between March 2020 and July 2021. A total of 63 individuals diagnosed with MS were examined, with 30 testing positive for both COVID-19 and MS; however, 33 individuals were positive only for MS. These individuals had presented at the hospital experiencing respiratory symptoms, including rhinorrhea, difficulty breathing, and cough. Various clinical aspects were evaluated, including age, gender, and the presence of COVID-19 symptoms. Statistical analyses included the Mann-Whitney t-test, Fisher’s exact test, and odds ratio calculations using SPSS-27 and R 4.2.3. Results: The study encompassed 63 MS patients, with 29 (46%) and 34 (54%) males and females, respectively. Of these patients, 30 individuals were positive for COVID-19. Most subjects were from Tehran province, Iran. Patients in the case group were significantly younger than those in the control group. Notably, dizziness, breath shortness, and vomiting were significantly more prevalent in MS patients following COVID-19. Conclusions: This study highlights the distinct clinical presentation of COVID-19 in individuals with MS. Dizziness, breath shortness, vomiting, and increased mortality were significantly associated with MS patients with COVID-19. The aforementioned findings underscore the importance of tailored management strategies for this unique patient population following the disease.