Long COVID Symptoms Persist in Individuals With Multiple Sclerosis, Study Finds

Individuals with multiple sclerosis (MS) experience an ongoing impact of post-COVID-19 symptoms, revealing a significant overlap between post-acute sequelae of SARS-CoV-2 infection (PASC) and MS-related symptoms.

“To better understand post-infectious symptoms in MS, we aimed to describe persistent symptoms following COVID-19 and other infections compared to those who had no infections and characterize the performance of the PASC score in those with MS,” wrote Amber Salter, Department of Neurology, Section on Statistical Planning and Analysis, UT Southwestern, Peter O’Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center in Dallas, TX, and coauthors.

The findings are based on data from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry and suggest that those with MS who contracted COVID-19 may experience lingering effects such as fatigue, brain fog, and autonomic dysfunction, complicating symptom management.

The researchers analyzed survey responses from 4787 individuals with MS, of whom 44.2% reported a confirmed COVID-19 infection. Among those who had COVID-19 more than 3 months prior, 15.9% met the criteria for PASC, a rate similar to that of uninfected participants (17.2%). However, individuals who experienced both COVID-19 and a non-COVID infection in the past 6 months showed a slightly higher prevalence of persistent symptoms (16.3%).

New persistent symptoms were reported by 15.5% of those with a prior COVID-19 infection. The most common lingering symptoms included fatigue (3.7%), brain fog (3.6%), weakness (2.5%), and malaise (2.7%). Notably, autonomic dysfunction—a condition affecting the nervous system’s regulation of involuntary functions such as heart rate and blood pressure—was more prevalent in individuals who had experienced a recent infection, whether COVID-19 or another illness.

The researchers also assessed symptoms using the PASC scoring system, which assigns points to specific symptoms such as loss of smell or taste, postexertional malaise, and chronic cough. When this scoring system was restricted to new persistent symptoms, only 1.5% of individuals with a prior COVID-19 infection met the PASC definition, compared to 0.23% of those with a non-COVID infection and 3.25% of those who had both.

“With the increased infection risk in persons with MS and potential for a range of infections to cause post-acute infection syndromes, improved methods and further investigation of these events are warranted,” concluded the study authors.

Reference

Salter A, Lancia S, Cutter GR, Fox RJ, Marrie RA. Post-acute sequela of COVID-19 infection in individuals with multiple sclerosis. Mult Scler. Published online January 3, 2025. doi:10.1177/13524585241310104