SARS-CoV-2 triggered relapse of multiple sclerosis

Finsterer, Josef

doi:10.1016/j.clineuro.2022.107210

Cited by 15 publications

(12 citation statements)

References 16 publications

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“…Fifteen case reports and case series reported the occurrence of MS relapse/pseudo-relapse or the onset of a first demyelinating event consistent with MS or CIS in 19 patients ( 57 , 63 , 65 – 69 , 76 – 79 , 81 , 82 , 84 , 86 ). Twelve observational case series and cohort studies documented the occurrence of relapses or pseudo-relapses among patients with a known diagnosis of MS and confirmed diagnosis of COVID-19 ( 58 – 61 , 64 , 71 – 75 , 83 , 85 ).…”

Section: Resultsmentioning

confidence: 99%

COVID-19 and the risk of CNS demyelinating diseases: A systematic review

et al. 2022

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BackgroundViral infections are a proposed possible cause of inflammatory central nervous system (CNS) demyelinating diseases, including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). During the past 2 years, CNS demyelinating events associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported, but causality is unclear.ObjectiveTo investigate the relationship between CNS demyelinating disease development and exacerbation with antecedent and/or concurrent SARS-CoV-2 infection.MethodsA systematic literature review of all publications describing either a new diagnosis or relapse of CNS demyelinating diseases (MS, NMOSD, MOGAD) in association with SARS-CoV-2 infection was performed utilizing PRISMA guidelines. Descriptive statistics were used for data analysis, using a case analysis approach.ResultsSixty-seven articles met the inclusion criteria for the study. Most of the reported cases of NMOSD (n = 13, 72.2% of reported cases) and MOGAD (n = 27, 96.5% of reported cases) were of new disease onset, presenting with typical clinical and radiographic features of these conditions, respectively. In contrast, reported MS cases varied amongst newly diagnosed cases (n = 10, 10.5% of reported cases), relapses (n = 63, 66.4%) and pseudo-relapses (n = 22, 23.2%). The median duration between COVID-19 infection and demyelinating event onset was 11.5 days (range 0–90 days) in NMOSD, 6 days (range−7 to +45 days) in MOGAD, and 13.5 days (range−21 to +180 days) in MS. Most cases received high-dose corticosteroids with a good clinical outcome.ConclusionBased upon available literature, the rate of CNS demyelinating events occurring in the setting of preceding or concurrent SARS-CoV-2 infection is relatively low considering the prevalence of SARS-CoV-2 infection. The clinical outcomes of new onset or relapsing MS, NMOSD, or MOGAD associated with antecedent or concurrent infection were mostly favorable. Larger prospective epidemiological studies are needed to better delineate the impact of COVID-19 on CNS demyelinating diseases.

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Section: Resultsmentioning

confidence: 99%

COVID-19 and the risk of CNS demyelinating diseases: A systematic review

et al. 2022

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“…It is interesting to know that new guidelines focus on the administration of rituximab as the first‐line treatment for pemphigus, since it leads to more cases of remission even after one cycle 19–22 . Our patient received rituximab for her underlying neurological disorder, MS, but this had done her favor as it led to complete resolution of cutaneous eruptions.…”

Section: Discussionmentioning

confidence: 98%

“…Another important issue was the contribution of SARS-CoV-2 in triggering new onset or exacerbations of neuro-immunological disease like MS. 18 This phenomenon occurred in our patient who was probably a case of It is interesting to know that new guidelines focus on the administration of rituximab as the first-line treatment for pemphigus, since it leads to more cases of remission even after one cycle. [19][20][21][22] Our patient received rituximab for her underlying neurological disorder, MS, but this had done her favor as it led to complete resolution of cutaneous eruptions. 4 | CONCLUSION SARS-Cov-2 infection could have led to any dermatologic condition, including insignificant and critical ones.…”

Section: Discussionmentioning

confidence: 99%

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New‐onset pemphigus foliaceus following SARS‐CoV‐2 infection and unmasking multiple sclerosis: A case report

Mohaghegh

Hatami

Refaghat

et al. 2022

Clinical Case Reports

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“…Another study revealed an upregulation in HERVs in children with mild or moderate COVID-19 but a decrease in those with a severe disease ( Tovo et al, 2021 ). However, literature data highlight a possible exacerbation of neurological conditions in cases with COVID-19, and particularly, a recent case series analysis concluded that SARS-CoV-2 infection may affect the MS or even cause a relapse ( Finsterer, 2022 , Michelena et al, 2022 ).…”

mentioning

confidence: 99%