Multiple sclerosis incidence in Al-Madinah Al-Munawwarah in Saudi Arabia before and after the COVID-19 pandemic: a retrospective cross-sectional study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20243628Keywords:
COVID-19, Pandemic, Demyelinating disorders, MSAbstract
Background: Many people have suffered from coronavirus 2019 (COVID-19) which was declared pandemic in 2020. More than a year ago, vaccination against COVID-19 offered hope of controlling this pandemic. Recent studies have reported that COVID-19 vaccine can boost immune responses, However, it triggers several neurological diseases such as multiple sclerosis (MS). However, there is insufficient data on COVID-19 infections as a risk factor for MS. Therefore, in this study our aim is to assess the incidence rate of MS before and after COVID-19 Pandemic and the associated findings that appeared in MS patients.
Methods: A retrospective cross-sectional study had been conducted using data of patients admitted with COVID-19 infection at King Fahad hospital, Al-Madinah Al-Munawwarah, Saudi Arabia from 2020 to 2024. The collected data had been analyzed using SPSS version 20 using data from medical reports.
Results: The overall number of all MS cases that we have collected were 383, the cases before COVID-19 pandemic were 125 cases while 147 cases were during and after COVID-19 pandemic. The brain and spinal lesions was higher than the cases before COVID-19 also, there was a statistically significant difference between the cases that had ataxia before MS before COVID-19 are lower than after COVID- with statistically significant difference.
Conclusions: The incident of cases increased after COVID-19, the mean age before COVID-19 was higher than the mean age of cases after COVID-19 with statistical significance difference.
References
Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol. 2020;92:4:401-2.
Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. The Lancet. 2020;395:10224:565-74.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Eng J Med. 2020;382:8:727-33.
Lima M, Aloizou AM, Siokas V, Bakirtzis C, Liampas I, Tsouris Z, et al. Coronaviruses and their relationship with multiple sclerosis: Is the prevalence of multiple sclerosis going to increase after the COVID-19 pandemia? Rev Neurosci. 2022;33(7):703-20.
Ghasemi N, Razavi S, Nikzad E. Multiple sclerosis: Pathogenesis, symptoms, diagnoses and cell-based therapy Cell J. 2017;19(1):1-10.
Assunta B, Gabriele DS, Francesca C, Valeria DA, Alessandra C, Paola DG, et al. Clinical onset and multiple sclerosis relapse after SARS-COV-2 infection. Neurology Int. Int J Mol Sci. 2024;25(8):4556.
Finsterer J. SARS-COV-2 triggered relapse of multiple sclerosis. Clin Neurol Neurosurg. 2022;215:107210.
Sobia S, Sylvette R, Alaa SM, Enitare O, Rihanat AA, Ahmed A, et al. Multiple sclerosis following SARS-COV-2 infection: A case report and literature review. Cureus. 2021;13(10):e19036.
Moore L, Ghannam M, Manousakis G. A first presentation of multiple sclerosis with concurrent COVID-19 infection. e Neurological Sci. 2020;22:100299.
Ismail II, Al-Hashel J, Alroughani R, Ahmed SF. A case report of multiple sclerosis after COVID-19 infection: Causality or coincidence? Neuroimmunol Rep. 2021;1:100008.
Palao M, Fernández-Díaz E, Gracia-Gil J, Romero-Sánchez CM, Díaz-Maroto I, Segura T, Multiple sclerosis following SARS-COV-2 infection. Mult Scler Relat Disord. 2020:45:102377.
OpenEpi epidemiologic-statistics (no date) OpenEpi Epidemiologic Statistics. Available at: http://www.OpenEpi.com/. Accessed on 23 April 2024.
Giannopapas V, Palaiodimou L, Kitsos D, Papagiannopoulou G, Stavrogianni K, Chasiotis A, et al. The Prevalence of Diabetes Mellitus Type II DMII in the Multiple Sclerosis Population: A Systematic Review and Meta-Analysis. J Clin Med. 2023;1215:4948.
Elzamarany E, Afifi L, El-Fayoumy NM, et al. Motor cortex rTMS improves dexterity in relapsing-remitting and secondary progressive multiple sclerosis. Acta Neurol Belg. 2016;1162:145-50.
Magyari M, Koch-Henriksen N, Pfleger CC, Sørensen PS. Gender and autoimmune comorbidity in multiple sclerosis. Mult Scler J. 2014;20:1244-51.
Tettey P, Simpson S, Taylor BV, Van Der Mei IAF. The co-occurrence of multiple sclerosis and type 1 diabetes: shared aetiologic features and clinical implication for MS etiology. J Neurol Sci. 2015;348:126-31.
Pozzilli V, Grasso EA, Tomassini V. Similarities and differences between multiple sclerosis and type 1 diabetes Diabetes. Metab Res Rev. 2022;38:1.
Frau J, Coghe G, Lorefice L, Fenu G, Cocco E. Infections and Multiple Sclerosis: From the World to Sardinia, from Sardinia to the World. Front Immunol. 2021;12:728677.
Haki M, Al-Biati HA, Al-Tameemi ZS, Ali IS, Al-Hussaniy HA. Review of multiple sclerosis: Epidemiology, etiology, pathophysiology, and treatment. Med Baltimore. 2024;1038:e37297.
Maroufi H, Moghadasi AN, Rezaei-Aliabadi H, Sahraian MA, Eskandarieh S. Medical history risk factors in primary progressive multiple sclerosis: A case-control study. Curr J Neurol. 2020;20:86-94.
Han H, Ma Q, Li C, Liu R, Zhao L, Wang W, et al. Profiling serum cytokines in COVID-19 patients reveals IL-6 and IL-10 are disease severity predictors Emerg. Microbes Infect. 2020;9:1123-30.
Lima M, Siokas V, Aloizou A-M, Liampas I, Mentis A-FA, Tsouris Z, et al. Unraveling the possible routes of SARS-COV-2 invasion into the central nervous system. Curr Treat Options Neurol. 2020;11:37.
Zarifkar P, Peinkhofer C, Benros ME, Kondziella D. Frequency of Neurological Diseases After COVID-19, Influenza A/B and Bacterial Pneumonia. Front Neurol. 2022;13:904796.
Waubant E, Lucas R, Mowry E, Graves J, Olsson T, Alfredsson L, et al. Environmental and genetic risk factors for MS: an integrated review. Ann Clin Transl Neurol. 2019;6:1905-22.
Al Jumah M, Bunyan R, Al Otaibi H, Al Towaijri G, Karim A, Al Malik Y, et al. Rising prevalence of multiple sclerosis in Saudi Arabia, a descriptive study. BMC Neurol. 2020;20:49.
Etemadifar M, Nourian SM, Nourian NS, Abtahi SH, Sayahi F, Saraf Z, et al. Early-onset multiple sclerosis in Isfahan, Iran: report of the demographic and clinical features of 221 patients. J Child Neurol 2016; 31: 932–937.
Tian DC, Zhang C, Yuan M, Yang X, Gu H, Li Z et al.Incidence of multiple sclerosis in China: A nationwide hospital-based study. Lancet Reg Health West Pac. 2020;1:100010.
Van Kempen ZL, Toorop AA, Sellebjerg F, Giovannoni G, Killestein J. Extended dosing of monoclonal antibodies in multiple sclerosis. Multiple Scler J. 2022;28(13):2001-9.
Meppiel E, Peiffer-Smadja N, Maury A, Bekri I, Delorme C, Desestret et al. Neurologic manifestations associated with COVID-19: A multicentre, registry. Clin Microbiol Infect. 2021;27:458.
Palao M, Fernández-Díaz E, Gracia-Gil J, Romero-Sánchez CM, Díaz-Maroto I, Segura T. Multiple sclerosis following SARS-CoV-2, infection. Mult Scler Relat Disord. 2020;45:102377.
Zanin L, Saraceno G, Panciani PP, Renisi G, Signorini L, Migliorati K, Fontanella M. SARS-CoV-2 can induce brain and spine demyelinating lesions. Acta Neurochir. 2020;162:1491-4.
Kataria S, Tandon M, Melnic V, Sriwastava S. A case series and literature review of multiple sclerosis and COVID-19: Clinical characteristics, outcomes and a brief review of immunotherapies. eNeurological Sci. 2020;21:100287.
Machhi J, Shahjin F, Das S, Patel M, Abdelmoaty MM, Cohen JD, et al. A Role for Extracellular Vesicles in SARS-CoV-2 Therapeutics, Prevention. J Neuroimmune Pharmacol. 2021;16:270-88.
Rochfort KD, Collins LE, McLoughlin A, Cummins PM. Tumour necrosis factor-α-mediated disruption of cerebrovascular endothelial barrier integrity in vitro involves the production of proinflammatory, interleukin-6. J Neurochem. 2016;136:564-72.
Zakaria M, Zamzam D, Hafeez M, Swelam M, Khater S, Fahmy M, et al. Clinical characteristics of patients with multiple sclerosis enrolled in a new registry in Egypt. Mult Scler Rel Disord. 2016;10:30-5.
Salama S, Marouf H, Ihab Reda M, Mansour AR, El Kholy O, Levy M. Clinical and radiological characteristics of neuromyelitis optica spectrum disorder in the North Egyptian Nile Delta. J Neuroimmunol. 2018;15;324:22-5.
