Objective To report initial results of a planned multicenter year‐long prospective study examining the risk and impact of COVID‐19 among persons with neuroinflammatory disorders (NID), particularly multiple sclerosis (MS). Methods In April 2020, we deployed online questionnaires to individuals in their home environment to assess the prevalence and potential risk factors of suspected COVID‐19 in persons with NID (PwNID) and change in their neurological care. Results Our cohort included 1115 participants (630 NID, 98% MS; 485 reference) as of 30 April 2020. 202 (18%) participants, residing in areas with high COVID‐19 case prevalence, met the April 2020 CDC symptom criteria for suspected COVID‐19, but only 4% of all participants received testing given testing shortages. Among all participants, those with suspected COVID‐19 were younger, more racially diverse, and reported more depression and liver disease. PwNID had the same rate of suspected COVID‐19 as the reference group. Early changes in disease management included telemedicine visits in 21% and treatment changes in 9% of PwNID. After adjusting for potential confounders, increasing neurological disability was associated with a greater likelihood of suspected COVID‐19 (OR adj = 1.45, 1.17–1.84). Interpretations Our study of real‐time, patient‐reported experience during the COVID‐19 pandemic complements physician‐reported MS case registries which capture an excess of severe cases. Overall, PwNID seem to have a risk of suspected COVID‐19 similar to the reference population.

OBJECTIVE:To test the association between physical function and the social environment in multiple sclerosis (MS), we quantified personal social networks.METHODS:In this cross-sectional study, we analyzed data from two academic MS centers, with center one serving as a discovery group, and center two as the extension group. We performed a meta-analysis of the centers to extend the analysis. We used responses from a questionnaire to map the structure and health habits of participants’ social networks, and the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) physical function scale (0-100, mean 50 for US general population) as the primary outcome. We applied multivariable models to test the association between network metrics and physical function.RESULTS:The discovery cohort included 263 MS patients: 81% were women, 96% non-Hispanic European, 78% relapsing MS, average age 50 (12.4) years, and mean disease duration 17 (12.3) years. The extension group included 163 patients, who were younger, more racially diverse, less physically disabled, and had shorter disease duration. In the meta-analysis, higher network constraint, a measure of tightly-bound networks, was associated with worse physical function (β=-0.163+0.047, p<0.001), while larger network effective size, a measure of clustered groups in the network, correlated with better physical function (β=0.134+0.046, p=0.003).CONCLUSIONS:Our study highlights personal networks as an important environmental factor associated with physical function in MS. Patients with close-knit networks had worse function than those with more open networks. Longitudinal studies are warranted to evaluate a causal relationship between network structure and physical impairment.