TY - JOUR
T1 - Risk of MS relapse and deterioration after COVID-19
T2 - A systematic review and meta-analysis
AU - Seyedmirzaei, Homa
AU - Salabat, Dorsa
AU - KamaliZonouzi, Sara
AU - Teixeira, Antônio L.
AU - Rezaei, Nima
N1 - Publisher Copyright:
© 2024
PY - 2024/3
Y1 - 2024/3
N2 - Background: Upper respiratory viral infections have long been considered triggers for multiple sclerosis (MS) relapse and exacerbation. The possible effects of SARS-CoV-2 infection on MS relapse and deterioration remain controversial. Methods: We systematically searched PubMed, Scopus, Embase, Cochrane, and Web of Science databases to find relevant studies assessing changes in relapse rates or Expanded Disability Status Scale (EDSS) following COVID-19 in people with MS. Meta-analyses were performed, and to investigate sources of heterogeneity, subgroup analysis, meta-regression, and sensitivity analysis were conducted. Results: We included 14 studies in our systematic review and meta-analysis. The meta-analysis demonstrated that COVID-19 was not associated with a rise in relapse rate (risk ratio (RR): 0.97, 95 % confidence interval (CI): 0.67, 1.41, p-value: 0.87) or a rise in EDSS (standardized mean difference (SMD): −0.09, 95 % CI: −0.22, 0.03, p-value: 0.13). The analysis of EDSS changes indicated a significant heterogeneity (I2: 55 %, p-value: 0.01). Other analyses were not statistically significant. Conclusions: COVID-19 infection was not associated with an increased risk of relapse and clinical deterioration in people with MS.
AB - Background: Upper respiratory viral infections have long been considered triggers for multiple sclerosis (MS) relapse and exacerbation. The possible effects of SARS-CoV-2 infection on MS relapse and deterioration remain controversial. Methods: We systematically searched PubMed, Scopus, Embase, Cochrane, and Web of Science databases to find relevant studies assessing changes in relapse rates or Expanded Disability Status Scale (EDSS) following COVID-19 in people with MS. Meta-analyses were performed, and to investigate sources of heterogeneity, subgroup analysis, meta-regression, and sensitivity analysis were conducted. Results: We included 14 studies in our systematic review and meta-analysis. The meta-analysis demonstrated that COVID-19 was not associated with a rise in relapse rate (risk ratio (RR): 0.97, 95 % confidence interval (CI): 0.67, 1.41, p-value: 0.87) or a rise in EDSS (standardized mean difference (SMD): −0.09, 95 % CI: −0.22, 0.03, p-value: 0.13). The analysis of EDSS changes indicated a significant heterogeneity (I2: 55 %, p-value: 0.01). Other analyses were not statistically significant. Conclusions: COVID-19 infection was not associated with an increased risk of relapse and clinical deterioration in people with MS.
KW - COVID-19
KW - EDSS
KW - Multiple sclerosis
KW - Relapse
KW - SARS-CoV-2
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UR - http://www.scopus.com/inward/citedby.url?scp=85184472717&partnerID=8YFLogxK
U2 - 10.1016/j.msard.2024.105472
DO - 10.1016/j.msard.2024.105472
M3 - Review article
C2 - 38316078
AN - SCOPUS:85184472717
SN - 2211-0348
VL - 83
JO - Multiple Sclerosis and Related Disorders
JF - Multiple Sclerosis and Related Disorders
M1 - 105472
ER -