Prolonged COVID-19 Symptoms Prevalent in Patients With Multiple Sclerosis

In a prospective and longitudinal cohort study, researchers examined the course of recovery from COVID-19 among patients with MS and sought to identify its predictors, such as patients’ physical and mental health status before COVID-19 infection.

 Nearly a third of patients with multiple sclerosis (MS) who recovered from COVID-19 experienced postacute sequelae, according to findings from a prospective and longitudinal cohort study published in Neurology Neuroimmunology & Neuroinflammation.

To date, it has been established that most patients with MS do not develop severe COVID-19, necessitating hospitalization. However, it remains unclear whether this patient population experiences prolonged acute symptoms.

The objective of the current study was to examine the course of recovery from COVID-19 in MS and to determine its predictors.

Data for this analysis were sourced from the United Kingdom (UK) MS Register (UKMSR) COVID-19 study. Since March 17, 2020, patients with MS living in the UK self-reported symptoms suggestive of COVID-19 (n=444) and were contacted by email every two weeks to reassess symptoms until they reported full recovery.

COVID-19 symptoms lasted less than 4 weeks among 371, 4 weeks or more among 165, and 12 weeks or more among 69, with an overall median duration of symptoms lasting 10 (interquartile range [IQR], 6-21) days.

Patients reporting symptoms at 4 or more weeks (n=95) and 12 or more weeks (n=60) weeks had new or worse fatigue (n=60 and n=41), lower respiratory tract symptoms (n=46 and n=35), new muscle pain (n=34 and n=27), gastrointestinal symptoms (n=33 and n=25), changes to smell or taste (n=28 and n=17), upper respiratory tract symptoms (n=21 and n=15), headache (n=20 and n=13), and fever (n=3 and n=3), respectively.

Recovery from COVID-19 associated with female gender (adjusted hazard ratio [aHR], 0.756; 95% CI, 0.609-0.937), anxiety or depression (aHR, 0.708; 95% CI, 0.533-0.941), and highest severity of MS (aHR, 0.614; 95% CI, 0.381-0.989).

This study may have been limited by including both self-reported and confirmed COVID-19 infection and by the low number of participants who reported full recovery (444 of 1096).

“Patients with MS are affected by postacute sequelae of COVID-19. Preexisting severe neurologic impairment or mental health problems appear to increase this risk,” stated the researchers. They concluded, “These findings can have implications in tailoring their post–COVID-19 rehabilitation.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Garjani A, Middleton RM, Nicholas R, Evangelou N. Recovery From COVID-19 in Multiple Sclerosis: A Prospective and Longitudinal Cohort Study of the United Kingdom Multiple Sclerosis Register. Published online November 30, 2021. doi:10.1212/NXI.0000000000001118