COVID-19 and multiple sclerosis
General Medicine, 2024, 26(2), 28-34.
P. Argirova1, T. Velyanova1,2, O. Boykinova1,2, M. Stoycheva3
1 Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University ‒ Plovdiv
2 Clinic of Infectious Diseases, UMHAT „Sv. Georgе“ ‒ Plovdiv
3 Research Institute, Medical University ‒ Plovdiv
Abstract. SARS-CoV-2 infection has an extremely varied clinical presentation including an asymptomatic or mild respiratory disease and severe, critical conditions with cardiovascular and nervous systems damage, multiple organ dysfunction and fatal outcome. Known risk factors for a severe course are advanced age, comorbidities, immunosuppression, and metabolic abnormalities. Multiple sclerosis is a chronic inflammatory degenerative disease of the central nervous system, and the immunosuppression is part of the therapeutic approach to the patient. The role of multiple sclerosis and its disease-modifying immunomodulatory therapy on the course and outcome of COVID-19 is unclear. The aim is to present the clinical course of COVID-19 in hospitalized patients with MS. Materials and methods. The study is retrospective and covers the period from March 2020 to August 2023. From total of 8518 patients with COVID-19 treated at Sveti George University Hospital in Plovdiv, 12 were identified with accompanying disease MS. Clinical, epidemiological, laboratory, microbiological, virological and imaging methods were used. Results. 66.7% of patients with COVID-19 and MS are women. The average age is 50.8 years. The most common clinical symptoms are fever, fatigue, cough and shortness of breath. Radiоlogic sings for pneumonia had 66.7% of the patients. Respiratory failure was observed in 33.3% as well as need for oxygen supplementation. One patient died (8.3%). Conclusions. The incidence of hospitalized COVID-19 patients with concomitant MS was low (0.14%). The role of disease-modifying therapy in MS is unclear. The proportion of patients with respiratory failure and the possibility of fatal outcome are probably related to other risk factors as well.
Key words: COVID-19, multiple sclerosis, PCR, SARS-CoV-2
Address for correspondence: Senior Assist. Petya Argirova, MD, PhD, e-mail: petia_med6@abv.bg