COVID-19 and Multiple Sclerosis: Predisposition and Precautions in Treatment
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COVID-19
COVID-19 and Multiple Sclerosis: Predisposition and Precautions in Treatment Shaghayegh Sadeghmousavi 1,2 & Nima Rezaei 3,4,5 Accepted: 31 August 2020 # Springer Nature Switzerland AG 2020
Abstract Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to Coronavirus disease 2019 (COVID19), is not always confined to the respiratory tract, while patients with can develop neurological manifestations. The patients with multiple sclerosis (MS) pose challenges in this pandemic situation, because of the immunosuppressive medications they get and the fact that viral infections may contribute to MS exacerbation and relapses as an environmental factor in genetically predisposed individuals. Herein, possible consequences of COVID-19 which may carry for the MS patients and the underlying mechanisms of its impact are discussed. Keywords SARS-CoV-2 . COVID-19 . Nervous system . Neurological symptoms . Multiple sclerosis
Introduction In December 2019, an outbreak of respiratory disease due to a novel coronavirus (CoV), named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred first in Wuhan, China; and then rapidly spread globally. The World Health Organization (WHO) named this disease coronavirus disease 2019 (COVID-19) [1–5]. In addition to the respiratory tract symptoms, COVID-19 patients can develop neurological symptoms, including dizziness, headache, impaired consciousness, acute cerebrovascular disease, encephalopathy, This article is part of the Topical Collection on COVID-19 * Nima Rezaei [email protected] 1
Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
2
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3
Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Dr Qarib St, Keshavarz Blvd, Tehran 14194, Iran
4
Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
5
Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
ataxia, seizure, peripheral nervous system involvement (taste, smell, and vision impairment such as optic neuritis, and Guillain-Barré syndrome), and nerve pain [6–14]. Also, based on autopsy studies, the presence of brain tissue edema and partial neuronal degeneration was confirmed in these patients [15]. One of the neurological involvements of CoVs that has been reported is their implication in chronic neuroinflammatory diseases, including multiple sclerosis (MS) [16–19]. In this study, we aimed to review the research into the impacts of COVID-19 on MS.
MS in COVID-19 Multiple sclerosis (MS) is a chronic immune-mediated and neurodegenerative disorder that can be developed by both genetic and environmental factors [20]. The major symptoms are sensory, visual, and motor impairments, fatigue, pain, and cognitive deficits [2
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