A first presentation of multiple sclerosis with concurrent COVID-19 infection

Moore, Lisa E.; Ghannam, Malik; Manousakis, Georgios

doi:10.1016/j.ensci.2020.100299

Cited by 44 publications

(42 citation statements)

References 19 publications

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“…However, to date, few reports concerning the development of MSassociated demyelination in COVID-19 patients shortly following the infection have been published (Palao et al, 2020, Domingues et al, 2020, Moore et al, 2021 (summarized in Table-3). Kataria et al have reported three RRMS patients who experienced worsening clinical symptoms following the COVID-19 contraction.…”

Section: Current Knowledge On Sars-cov-2 and Ms-associated Demyelinationmentioning

confidence: 99%

COVID-19 and the Risk of Relapse in Multiple Sclerosis Patients: A Fight with No Bystander Effect?

Etemadifar

Sedaghat

Aghababaee

et al. 2021

Multiple Sclerosis and Related Disorders

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Background: COVID-19 is speculated to increase the likelihood of relapsing-remitting multiple sclerosis (RRMS) exacerbation. Objective: To investigate the association between contraction of COVID-19 and incidence of acute MS attacks in RRMS patients six months post-infection. Methods: This retrospective cohort study compares the risk of relapse in RRMS patients with (n=56) and without COVID-19 (n=69). Incidence of relapse was recorded for six-month following contraction of COVID-19. Incidence of RRMS exacerbation in patients with COVID-19 was compared to patients without COVID-19 (the independent control group) and the same patients six months prior to the COVID-19 pandemic. Results: A lower incidence rate of RRMS exacerbation was observed in patients that contracted COVID-19 than in patients who did not contract COVID-19 (incidence rate ratio: 0.275; p=0.026). Self-controlled analysis showed no significant difference in relapse rates before the COVID-19 pandemic and after contracting . The relapse risk was not different between patients who had been hospitalized due to COVID-19 severity and those who had not (p=0.710). Conclusion: COVID-19 contraction may not increase the risk of acute MS attacks shortly following contraction. We hypothesize that COVID-19-associated lymphopenia may partly preclude the autoreactive memory cells from expansion and initiating relapses through a so-called bystander effect of COVID-19 infection.

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Section: Current Knowledge On Sars-cov-2 and Ms-associated Demyelinationmentioning

confidence: 99%

COVID-19 and the Risk of Relapse in Multiple Sclerosis Patients: A Fight with No Bystander Effect?

Etemadifar

Sedaghat

Aghababaee

et al. 2021

Multiple Sclerosis and Related Disorders

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“…We report a case of CNS demyelination following SARS-CoV-2 infection, that fulfilled the revised 2017 McDonald diagnostic criteria for MS. To our knowledge, this is the second published case report ( Moore et al, 2021 Mar 1 ), and the first from Middle East and North Africa (MENA) region. Both cases presented with ataxia, showed positive OCBs in CSF, and multiple demyelinating lesions in the brain MRI, with normal spine.…”

Section: Discussionmentioning

confidence: 82%

A case report of multiple sclerosis after COVID-19 infection: causality or coincidence?

Ismail

Al-Hashel

Alroughani

et al. 2021

Neuroimmunology Reports

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Introduction Since the declaration of COVID-19 pandemic, several cases of demyelination of both peripheral and central nervous systems have been reported. The association of viral infection and the development of CNS demyelination has long been studied, and this link has recently been reported following SARS-CoV-2 infection as well. Case report We report a case of a 36-year-old male who developed CNS demyelinating disease, that fulfilled the diagnostic criteria of multiple sclerosis (MS), 2 months after laboratory-confirmed infection with SARS-CoV-2. Conclusion To our knowledge, this is the second published case report of MS in association with COVID-19 infection, and the first case from Middle East and North Africa (MENA) region, adding to the growing literature of a probable causal relationship between SARS‐CoV‐2 infection and the development of MS.

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“…Both cases report the presence of autoantibodies with known association to SLE, including anti-La, anti-CCP, anti-SSA/Ro [72], ANA and anti-dsDNA antibodies [73]. Some patients have also been found to meet the criteria for diagnosis of MS following COVID-19 [74][75][76]. In each of these cases, markers of autoimmunity (e.g., ANA, anti-La) as well as autoantibodies to neuronal targets aquaporin-4 and myelin oligodendrocyte glycoprotein were negative, suggesting that autoantibodies may not always be involved in the aetiologies of these COVID-19 related autoimmune-like conditions.…”

Section: Systemic Lupus Erythematosus Multiple Sclerosis and Systemic Rheumatoid Diseasementioning

confidence: 99%

Adaptive Immunity and the Risk of Autoreactivity in COVID-19

Moody

Wilson

Flanagan

et al. 2021

IJMS

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While first and foremost considered a respiratory infection, COVID-19 can result in complications affecting multiple organs. Immune responses in COVID-19 can both protect against the disease as well as drive it. Insights into these responses, and specifically the targets being recognised by the immune system, are of vital importance in understanding the side effects of COVID-19 and associated pathologies. The body’s adaptive immunity recognises and responds against specific targets (antigens) expressed by foreign pathogens, but not usually to target self-antigens. However, if the immune system becomes dysfunctional, adaptive immune cells can react to self-antigens, which can result in autoimmune disease. Viral infections are well reported to be associated with, or exacerbate, autoimmune diseases such as multiple sclerosis (MS) and systemic lupus erythematosus (SLE). In COVID-19 patients, both new onset MS and SLE, as well as the occurrence of other autoimmune-like pathologies, have been reported. Additionally, the presence of autoantibodies, both with and without known associations to autoimmune diseases, have been found. Herein we describe the mechanisms of virally induced autoimmunity and summarise some of the emerging reports on the autoimmune-like diseases and autoreactivity that is reported to be associated with SARS-CoV-2 infection.

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A first presentation of multiple sclerosis with concurrent COVID-19 infection

Cited by 44 publications

References 19 publications

COVID-19 and the Risk of Relapse in Multiple Sclerosis Patients: A Fight with No Bystander Effect?

COVID-19 and the Risk of Relapse in Multiple Sclerosis Patients: A Fight with No Bystander Effect?

A case report of multiple sclerosis after COVID-19 infection: causality or coincidence?

Adaptive Immunity and the Risk of Autoreactivity in COVID-19

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