Did COVID-19 Pandemic Change the Course of Multiple Sclerosis? A Retrospective Eight-Year Study.

Did COVID-19 Pandemic Change the Course of Multiple Sclerosis? A Retrospective Eight-Year Study.

Publication date: Dec 01, 2025

The COVID-19 pandemic was a special situation for patients treated with disease-modifying therapies (DMTs). Infections may provoke disease activity and determine the choice of DMTs. Moreover, DMTs create a potentially increased risk of infections. The study aimed to assess the impact of the COVID-19 pandemic and the importance of COVID-19 vaccination on the course of multiple sclerosis (MS). The 8-year single-center retrospective cohort study compared treatment changes and infection incidence in 115 MS patients before and during the COVID-19 pandemic, as well as COVID-19 incidence and severity before and after COVID-19 vaccination. A multivariate approach assessed the effects of specific factors (age, sex, disease duration, prognostic profile, disease activity before the pandemic, DMTs, and infections) on the course of MS. Relapse activity was the most common reason for therapy change, with no significant differences (56. 52% vs. 61. 52%, p = 0. 998) before and during the pandemic. There were no differences in the rate of infections before and during the pandemic (67. 82% vs. 55. 65%, p = 0. 16). The severity of COVID-19 courses showed a significant improvement after vaccination (p = 0. 047). In the multivariable approach, the only significant factor associated with a higher risk of relapse was disease activity before the pandemic period (OR = 6. 80, p = 0. 010). The COVID-19 pandemic did not affect the course of MS in long-term follow-up. The only factor associated with relapse activity during the pandemic period was disease activity in the pre-pandemic period. COVID-19 vaccination may be an essential tool in the care of MS patients.

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Concepts Keywords
Covid COVID‐19 pandemic
Retrospective COVID‐19 vaccination
Sclerosis infections
Vaccination multiple sclerosis
predicting factors
therapy change

Semantics

Type Source Name
disease MESH COVID-19 Pandemic
disease MESH Multiple Sclerosis
disease MESH Infections
disease MESH Relapse
disease MESH relapsing remitting multiple sclerosis
pathway REACTOME Immune System
pathway REACTOME Reproduction
drug DRUGBANK Isoxaflutole
disease MESH severe acute respiratory syndrome
disease MESH lymphopenia
drug DRUGBANK Dimethyltryptamine
disease MESH included
drug DRUGBANK Natalizumab
drug DRUGBANK Cladribine
drug DRUGBANK Dimethyl fumarate
drug DRUGBANK Teriflunomide
drug DRUGBANK Trestolone
drug DRUGBANK Gadolinium
disease MESH obesity
drug DRUGBANK Nicotine
drug DRUGBANK Chlordiazepoxide
disease MESH fever
disease MESH dis
drug DRUGBANK Fingolimod
drug DRUGBANK Ocrelizumab
drug DRUGBANK Ozanimod
drug DRUGBANK Ofatumumab
disease MESH demyelinating diseases
disease MESH neuromyelitis optica spectrum disorders
disease MESH Pneumonia
disease MESH Urinary tract infections
disease MESH infectious diseases
disease MESH eye infection
disease MESH Neuroinflammation
disease MESH Upper Respiratory Tract Infections
disease MESH Mul
disease MESH Sclerosis
disease MESH Neurological Disorders
disease MESH myelitis

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