How quickly do people with MS recover from Covid-19?
The study in brief
Most people with MS who develop Covid-19 will have mild to moderate symptoms and will not develop serious complications which require hospital care. However, they may still experience long-term effects of Covid-19. This study was designed to find out how well people with MS recover from mild to moderate Covid-19 and the factors that influence recovery.
7,977 people with MS took part in the UK MS Register Covid-19 study. People who reported having Covid-19 were invited to complete fortnightly questionnaires until they considered themselves fully recovered from Covid-19. The association between Covid-19 recovery and factors including age, gender, type of MS, levels of disability and mental health status were analysed.
Regular updates from 571 participants were included in the final analysis.
Most people with MS who developed Covid-19 recovered within an average of 10 days. About 30% experienced Covid-19 symptoms for more than 4 weeks and about 12% for more than 12 weeks. People with higher disability, mental health problems, and women were more likely to experience persistent symptoms. The authors suggest the results will provide useful information to tailor post-Covid-19 rehabilitation. The results also highlight the importance of vaccination against Covid-19 in those who are most vulnerable to long-term effects.
The study in more detail
Background
Most people with MS who develop Covid-19 will have mild to moderate symptoms and will not develop serious complications which require hospital care. However, they may still experience long-term effects of Covid-19. This study was designed to find out how well people with MS recover from mild to moderate Covid-19 and the factors that influence recovery.
How this study was carried out
7,977 people with MS took part in the UK MS Register Covid-19 study. People who reported having Covid-19 were invited to complete fortnightly questionnaires until they considered themselves fully recovered from Covid-19. The questionnaire asked participants which symptoms of Covid-19 they were still experiencing. Background details about each participant, which they had previously provided is held as part of the Register. Details held include age, gender, type of MS, levels of disability and mental health status. The association between Covid-19 recovery and these background details was analysed to find factors that might influence recovery.
What was found?
1096 participants reported having Covid-19 and of these 599 provided regular updates of their Covid recovery. 28 participants (4.7%) were hospitalised due to their Covid infection and were excluded from the final analysis of 571 people.
77.8% reported full recovery from Covid-19 within the study period. The average recovery time was 10 days.
At least 165 participants (29.7%) had Covid-19 symptoms which lasted for more than 4 weeks and 69 (12.4%) for more than 12 weeks. Participants with pre-Covid self-assessed EDSS scores greater than 7 (unable to walk more than 5 metres with walking aid), participants with probable anxiety and/or depression before Covid-19, and women were more likely to report delayed recovery. Other MS-related factors such as disease duration or disease modifying therapies did not appear to influence recovery from Covid-19.
More than 80% of participants with persistent Covid-19 symptoms had symptoms that were not typical for MS, such as breathing difficulties, sore throat, stomach ache and diarrhoea.
What does it mean?
The good news from this study is that most people with MS who developed Covid-19 recovered within an average of 10 days. About 30% experienced Covid-19 symptoms for more than 4 weeks and about 12% for more than 12 weeks. People with higher disability, mental health problems, and women were more likely to experience persistent symptoms. The authors suggest the results will provide useful information to tailor post-Covid-19 rehabilitation. The results also highlight the importance of vaccination against Covid-19 in those who are most vulnerable to long-term effects of infection.
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.
Neurology Neuroimmunology and Neuroinflammation 2022; 9: e1118.
Read the full study
Find out more about long Covid
Long Covid is a term used to describe the effects of Covid-19 that continue for weeks or months beyond the initial illness. NICE (National Institute for Health and Care Excellence) defines long Covid as lasting for more than 12 weeks, although some people consider symptoms that last more than eight weeks to be long Covid.
The most recent analysis from the Office of National Statistics estimates that 2.1% of the general population were experiencing self-reported long Covid (symptoms persisting for more than four weeks after the first suspected Covid-19 infection) as of 2 January 2022.
If you are worried about new or ongoing symptoms four or more weeks after having Covid-19, there are resources available which can help you to understand what has happened and what you might expect as part of your recovery. The time it takes to recover from Covid-19 is different for everyone, and the length of your recovery is not necessarily related to the severity of your initial illness or whether you were in hospital.
NHS England
Long-term effects of coronavirus
Your COVID Recovery
NHS Scotland
Long-term effects of COVID-19 (long COVID)
NHS Wales
Getting support for recovery from Covid-19 (long Covid)
You can also download the COVID recovery App
NHS Northern Ireland
Long Covid
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Oh J, Walker B, Giovannoni G, Jack D, Dangond F, Nolting A, Aldridge J, Lebson LA, Leist TP.
Treatment-emergent adverse events occurring early in the treatment course of cladribine tablets in two phase 3 trials in multiple sclerosis
Mult Scler J Exp Transl Clin. 2021 Jul 13;7(3):20552173211024298. doi: 10.1177/20552173211024298. eCollection 2021 Jul-Sep.
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Smoot K, Chen C, Stuchiner T, Lucas L, Grote L, Cohan S.
Clinical outcomes of patients with multiple sclerosis treated with ocrelizumab in a US community MS center: an observational study
BMJ Neurol Open. 2021 Jul 7;3(2):e000108. doi: 10.1136/bmjno-2020-000108. eCollection 2021.
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Tsantes E, Curti E, Ferraro D, Lugaresi A, Baldi E, Montepietra S, Immovilli P, Simone AM, Mancinelli L, Strumia S, Vitetta F, Foschi M, Ferri C, Ferrarini C, Sola P, Granella F.
Dimethyl fumarate-induced lymphocyte count drop is related to clinical effectiveness in relapsing-remitting multiple sclerosis
Eur J Neurol. 2021 Jan;28(1):269-277. doi: 10.1111/ene.14538. Epub 2020 Oct 17.
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Giovannoni G, Galazka A, Schick R, Leist T, Comi G, Montalban X, Damian D, Dangond F, Cook S.
Pregnancy outcomes during the clinical development program of cladribine in multiple sclerosis: an integrated analysis of safety
Drug Saf. 2020 Jul;43(7):635-643. doi: 10.1007/s40264-020-00948-x.
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Prosperini L, Mancinelli CR, Solaro CM, Nociti V, Haggiag S, Cordioli C, De Giglio L, De Rossi N, Galgani S, Rasia S, Ruggieri S, Tortorella C, Capra R, Mirabella M, Gasperini C.
Induction versus escalation in multiple sclerosis: a 10-year real world study
Neurotherapeutics. 2020 Jul;17(3):994-1004. doi: 10.1007/s13311-020-00847-0.
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Drugs in development
Reich DS, Arnold DL, Vermersch P, Bar-Or A, Fox RJ, Matta A, Turner T, Wallström E, Zhang X, Mareš M, Khabirov FA, Traboulsee A; Tolebrutinib Phase 2b Study Group.
Safety and efficacy of tolebrutinib, an oral brain-penetrant BTK inhibitor, in relapsing multiple sclerosis: a phase 2b, randomised, double-blind, placebo-controlled trial
Lancet Neurol. 2021 Sep;20(9):729-738. doi: 10.1016/S1474-4422(21)00237-4.
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Brown JWL, Cunniffe NG, Prados F, Kanber B, Jones JL, Needham E, Georgieva Z, Rog D, Pearson OR, Overell J, MacManus D, Samson RS, Stutters J, Ffrench-Constant C, Gandini Wheeler-Kingshott CAM, Moran C, Flynn PD, Michell AW, Franklin RJM, Chandran S, Altmann DR, Chard DT, Connick P, Coles AJ.
Safety and efficacy of bexarotene in patients with relapsing-remitting multiple sclerosis (CCMR One): a randomised, double-blind, placebo-controlled, parallel-group, phase 2a study
Lancet Neurol. 2021 Sep;20(9):709-720. doi: 10.1016/S1474-4422(21)00179-4.
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Correale J.
BTK inhibitors as potential therapies for multiple sclerosis
Lancet Neurol. 2021 Sep;20(9):689-691. doi: 10.1016/S1474-4422(21)00250-7.
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Calabresi PA.
Trials and tribulations on the path to remyelination
Lancet Neurol. 2021 Sep;20(9):686-687. doi: 10.1016/S1474-4422(21)00253-2.
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Comi G, Dadon Y, Sasson N, Steinerman JR, Knappertz V, Vollmer TL, Boyko A, Vermersch P, Ziemssen T, Montalban X, Lublin FD, Rocca MA, Volkinshtein R, Rubinchick S, Halevy N, Filippi M.
CONCERTO: A randomized, placebo-controlled trial of oral laquinimod in relapsing-remitting multiple sclerosis
Mult Scler. 2021 Aug 11:13524585211032803. doi: 10.1177/13524585211032803. Online ahead of print.
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Families
Masterson-Algar P, Williams S.
"Thrown into the deep end": mapping the experiences of young people living in a family affected by a neurological condition
Qual Health Res. 2020 Apr;30(5):717-729. doi: 10.1177/1049732319900498. Epub 2020 Jan 29.
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Gender
Anderson A, Dierkhising J, Rush G, Carleton M, Rosendale N, Bove R.
Experiences of sexual and gender minority people living with multiple sclerosis in Northern California: An exploratory study
Mult Scler Relat Disord. 2021 Oct;55:103214. doi: 10.1016/j.msard.2021.103214. Epub 2021 Aug 14.
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Other treatments
Simpson-Yap S, Nag N, Probst Y, Jelinek G, Neate S.
Higher-quality diet and non-consumption of meat are associated with less self-determined disability progression in people with multiple sclerosis: A longitudinal cohort study
Eur J Neurol. 2022 Jan;29(1):225-236. doi: 10.1111/ene.15066. Epub 2021 Aug 26.
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Castelnovo G, Gerlach O, Freedman MS, Bergmann A, Sinay V, Castillo-Triviño T, Kong G, Koster T, Williams H, Gafson AR, Killestein J.
Safety, patient-reported well-being, and physician-reported assessment of walking ability in patients with multiple sclerosis for prolonged-release fampridine treatment in routine clinical practice: results of the LIBERATE study
CNS Drugs. 2021 Sep;35(9):1009-1022. doi: 10.1007/s40263-021-00840-x. Epub 2021 Jul 28.
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Cohen JA, Cameron MH, Goldman MD, Goodman AD, Miller AE, Rollins A, Llorens L, Patni R, Elfont R, Johnson R.
A Phase 3, double-blind, placebo-controlled efficacy and safety study of ADS-5102 (Amantadine) extended-release capsules in people with multiple sclerosis and walking impairment
Mult Scler. 2021 Aug 27:13524585211035333. doi: 10.1177/13524585211035333. Online ahead of print.
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Heidari Z, Shahrbanian S, Chiu C.
Massage therapy as a complementary and alternative approach for people with multiple sclerosis: a systematic review
Disabil Rehabil. 2021 Aug 1:1-12. doi: 10.1080/09638288.2021.1949051. Online ahead of print.
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Wahls TL, Titcomb TJ, Bisht B, Eyck PT, Rubenstein LM, Carr LJ, Darling WG, Hoth KF, Kamholz J, Snetselaar LG.
Impact of the Swank and Wahls elimination dietary interventions on fatigue and quality of life in relapsing-remitting multiple sclerosis: The WAVES randomized parallel-arm clinical trial
Mult Scler J Exp Transl Clin. 2021 Jul 31;7(3):20552173211035399. doi: 10.1177/20552173211035399. eCollection 2021 Jul-Sep.
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Meuth SG, Henze T, Essner U, Trompke C, Vila Silván C.
Tetrahydrocannabinol and cannabidiol oromucosal spray in resistant multiple sclerosis spasticity: consistency of response across subgroups from the SAVANT randomized clinical trial
Int J Neurosci. 2020 Dec;130(12):1199-1205. doi: 10.1080/00207454.2020.1730832. Epub 2020 Mar 1.
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Maayah ZH, Dyck JRB.
The pharmacological effects of inhaled cannabis on pain in patients with multiple sclerosis: risks versus rewards
Inflamm Res. 2020 Nov;69(11):1073-1076. doi: 10.1007/s00011-020-01396-0. Epub 2020 Aug 29.
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Arpín EC.
Efficacy and safety of fampridine for walking disability in multiple sclerosis
Neurodegener Dis Manag. 2020 Oct;10(5):277-287. doi: 10.2217/nmt-2020-0024. Epub 2020 Aug 7.
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Pregnancy and childbirth
Sadovnick D, Criscuoli M, Yee I, Carruthers R, Schabas A, Smyth P.
The road to conception for women with multiple sclerosis
Mult Scler J Exp Transl Clin. 2021 Jul 15;7(3):20552173211032313. doi: 10.1177/20552173211032313. eCollection 2021 Jul-Sep.
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Provision of care
Duddy M, Wilkinson C, Medhurst S, Rhys K.
Results from SPECTRUM: A survey of healthcare professionals to understand current diagnosis and management practices for secondary progressive multiple sclerosis in the United Kingdom
Mult Scler Relat Disord. 2021 Oct;55:103174. doi: 10.1016/j.msard.2021.103174. Epub 2021 Jul 26.
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Fernandes L, Allen CM, Williams T, Tallantyre E, Evangelou N, Chataway J, Ford HL; UK MS Trials and Registries Consortium investigators.
The contemporary role of MRI in the monitoring and management of people with multiple sclerosis in the UK
Mult Scler Relat Disord. 2021 Oct;55:103190. doi: 10.1016/j.msard.2021.103190. Epub 2021 Aug 2.
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Negri L, Cilia S, Falautano M, Grobberio M, Niccolai C, Pattini M, Pietrolongo E, Quartuccio ME, Viterbo RG, Allegri B, Amato MP, Benin M, De Luca G, Gasperini C, Minacapelli E, Patti F, Trojano M, Bassi M.
Job satisfaction among physicians and nurses involved in the management of multiple sclerosis: the role of happiness and meaning at work
Neurol Sci. 2021 Aug 7:1-8. doi: 10.1007/s10072-021-05520-8. Online ahead of print.
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Kraft AK, Berger K.
Quality of care for patients with multiple sclerosis-a review of existing quality indicators
Front Neurol. 2021 Aug 5;12:708723. doi: 10.3389/fneur.2021.708723. eCollection 2021.
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Psychological aspects
Giovannetti AM, Solari A, Pakenham KI.
Effectiveness of a group resilience intervention for people with multiple sclerosis delivered via frontline services
Disabil Rehabil. 2021 Aug 18:1-11. doi: 10.1080/09638288.2021.1960441. Online ahead of print.
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Raimo S, Santangelo G, Trojano L.
The emotional disorders associated with multiple sclerosis
Handb Clin Neurol. 2021;183:197-220. doi: 10.1016/B978-0-12-822290-4.00009-8.
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Rehabilitation
Srp M, Capek V, Gal O, Havrdova EK, Jech R, Korteova R, Novotna K, Ruzicka E, Ruzickova H, Srpova B, Hoskovcova M.
Severely disabled multiple sclerosis patients can achieve the performance of healthy subjects after expiratory muscle strength training
Mult Scler Relat Disord. 2021 Oct;55:103187. doi: 10.1016/j.msard.2021.103187. Epub 2021 Aug 5.
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Ghahfarrokhi MM, Banitalebi E, Negaresh R, Motl RW.
Home-based exercise training in multiple sclerosis: A systematic review with implications for future research
Mult Scler Relat Disord. 2021 Oct;55:103177. doi: 10.1016/j.msard.2021.103177. Epub 2021 Jul 27.
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Suárez-Iglesias D, Bidaurrazaga-Letona I, Sanchez-Lastra MA, Gil SM, Ayán C.
Effectiveness of equine-assisted therapies for improving health outcomes in people with multiple sclerosis: A systematic review and meta-analysis
Mult Scler Relat Disord. 2021 Oct;55:103161. doi: 10.1016/j.msard.2021.103161. Epub 2021 Jul 23.
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Raats J, Lamers I, Merken I, Boeckmans J, Soler BM, Normann B, Arntzen EC, Feys P.
The content and effects of trunk rehabilitation on trunk and upper limb performance in people with Multiple Sclerosis: a systematic review
Eur J Phys Rehabil Med. 2021 Sep 1. doi: 10.23736/S1973-9087.21.06689-2. Online ahead of print.
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Leonardi S, Maggio MG, Russo M, Bramanti A, Arcadi FA, Naro A, Calabrò RS, De Luca R.
Cognitive recovery in people with relapsing/remitting multiple sclerosis: A randomized clinical trial on virtual reality-based neurorehabilitation
Clin Neurol Neurosurg. 2021 Sep;208:106828. doi: 10.1016/j.clineuro.2021.106828. Epub 2021 Jul 21.
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Mehrabani G, Aminian S, Norton S, Motl RW, Manns PJ.
Preliminary efficacy of the "SitLess with MS" intervention for changing sedentary behaviour, symptoms, and physical performance in multiple sclerosis
Disabil Rehabil. 2021 Aug 25:1-8. doi: 10.1080/09638288.2021.1966520. Online ahead of print.
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Correale L, Buzzachera CF, Liberali G, Codrons E, Mallucci G, Vandoni M, Montomoli C, Bergamaschi R.
Effects of combined endurance and resistance training in women with multiple sclerosis: a randomized controlled study
Front Neurol. 2021 Aug 5;12:698460. doi: 10.3389/fneur.2021.698460. eCollection 2021.
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Sconza C, Negrini F, Di Matteo B, Borboni A, Boccia G, Petrikonis I, Stankevičius E, Casale R.
Robot-assisted gait training in patients with multiple sclerosis: a randomized controlled crossover trial
Medicina (Kaunas). 2021 Jul 14;57(7):713. doi: 10.3390/medicina57070713.
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Silveira SL, Baird JF, Motl RW.
Rates, patterns, and correlates of fitness tracker use among older adults with multiple sclerosis
Disabil Health J. 2021 Jan;14(1):100966. doi: 10.1016/j.dhjo.2020.100966. Epub 2020 Jul 31.
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Buoite Stella A, Pasquin F, Morrison SA, Morelli ME, Dinoto A, Bratina A, Bosco A, Sartori A, Giudici F, Manganotti P.
Effects of a cooling vest with sham condition on walking capacity in heat-sensitive people with multiple sclerosis
Eur J Appl Physiol. 2020 Nov;120(11):2467-2476. doi: 10.1007/s00421-020-04478-3. Epub 2020 Aug 20.
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Sandroff BM, Jones CD, Baird JF, Motl RW.
Systematic review on exercise training as a neuroplasticity-inducing behavior in multiple sclerosis
Neurorehabil Neural Repair. 2020 Jul;34(7):575-588. doi: 10.1177/1545968320921836. Epub 2020 May 26.
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Munari D, Fonte C, Varalta V, Battistuzzi E, Cassini S, Montagnoli AP, Gandolfi M, Modenese A, Filippetti M, Smania N, Picelli A.
Effects of robot-assisted gait training combined with virtual reality on motor and cognitive functions in patients with multiple sclerosis: A pilot, single-blind, randomized controlled trial
Restor Neurol Neurosci. 2020;38(2):151-164. doi: 10.3233/RNN-190974.
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Stem cells
Smith JA, Nicaise AM, Ionescu RB, Hamel R, Peruzzotti-Jametti L, Pluchino S.
Stem cell therapies for progressive multiple sclerosis
Front Cell Dev Biol. 2021 Jul 9;9:696434. doi: 10.3389/fcell.2021.696434. eCollection 2021.
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Symptoms and symptom management
Alvino B, Arianna F, Assunta B, Antonio C, Emanuele D, Giorgia M, Leonardo S, Daniele S, Renato D, Buscarinu MC, Massimiliano M, Crisafulli SG, Aurora Z, Gabri Nicoletti C, Marco S, Viola B, Francesco P, Marfia AG, Grazia S, Valentina S, Davide O, Giovanni S, Gioacchino T, Gallo A.
Prevalence and predictors of bowel dysfunction in a large multiple sclerosis outpatient population: an Italian multicenter study
J Neurol. 2021 Aug 4. doi: 10.1007/s00415-021-10737-w. Online ahead of print.
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Balchin R, Hersh D, Grantis J, Godfrey M.
"Ode to confidence": Poetry groups for dysarthria in multiple sclerosis
Int J Speech Lang Pathol. 2020 Jun;22(3):347-358. doi: 10.1080/17549507.2020.1739333. Epub 2020 Mar 25.
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The ADAMS project
25/05/2022 - 00:00
Dr Benjamin Jacobs spoke to us about a new study on the genetics of MS in people from minority ethnic backgrounds which may eventually shed light on why MS can be more severe for Black and Asian people.


Is a ketogenic diet good for people with multiple sclerosis?
18/05/2022 - 00:00
Researchers assessed whether a ketogenic diet, low in carbohydrates and high in fats, is suitable for people with multiple sclerosis.


Mayzent (siponimod) use expanded in England for secondary progressive multiple sclerosis
03/05/2022 - 00:00
NHS England has agreed that Mayzent can be prescribed for people with active secondary progressive multiple sclerosis whose disability has increased for at least 6 months, unrelated to relapses, and while taking a disease modifying drug.

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