Impact of the SARS-coV2 pandemic on patients with multiple sclerosis: A Tunisian study

Naguez, Mouna; Younes, Samia

Background and aims: In the context of SARS-coV2 pandemic, patients with multiple sclerosis (MS) constitute a vulnerable population due to the assumptions made about the risk of severe infection and the limitation of access to health care. We aim to study the sanitary and therapeutic impact of the SARS-cov2 out break on patients with MS. Methods: We conducted a cross-sectional study including patients followed for MS. The study period was divided into two: pre-pandemic (October to March 2020) and pandemic (March to June 2020). The diagnosis of MS was selected according to the criteria of Mc Donald (2017). Added to collecting data from medical files, we carried out a telephone questionnaire regarding therapeutic compliance, aggravation or installation of new neurological symptoms. Results: Seventy-two patients (mean age = 32.6 years, mean EDSS = 3.8) were included. During confinement, 16 patients stopped their basic treatment because of the non-authorization of inter urban travel and the fear of contamination by SARS-cov2 upon arrival at hospitals Compared to the pre-pandemic period during which 24 patients (50% discontinuing treatment) had a relapse, 20 patients (16 without basic treatment) reported worsening of neurological symptoms and the use of corticosteroid therapy in consulting (50 %) and hospitalized patients. Multivariate statistical analysis showed that non compliance and relapses' frequency did not differ before and during pandemic and that the occurrence of relapses is correlated with non-adherence to therapy. Conclusions: It is necessary to make informed decisions about MS treatment management in order to minimize the health impact of this pandemic.