The Prevalence of Multiple Sclerosis Relapse following COVID-19 infection vs COVID-19 Vaccine

Abstract

Background: Microbial infections can induce immune responses and exacerbate the symptoms of patients with autoinflammatory diseases such as multiple sclerosis (MS). Several studies have suggested that COVID-19 infection could exacerbate MS symptoms and promote relapse. Although, COVID-19 vaccination is the primary strategy to prevent and decrease infection COVID-19 vaccine hesitancy has been observed among MS patients due to concerns about vaccine safety and its adverse effects. we designed this systematic review and meta-analysis to investigate the prevalence of relapses in MS patients following COVID-19 infection and vaccination.Methods: We systematically searched four databases including, PubMed, Web of Science, Scopus, and Embase. We included any cohort, case-control, or cross-sectional study about the relapse rate in MS patients following either COVID-19 infection or COVID vaccination.Results: After screening 21 studies met our inclusion criteria and entered our systematic review and meta-analysis. The prevalence of acute relapse following COVID-19 vaccine was 2% (95% CI 2%-3%) (Figure 2) which was lower compared to the prevalence of relapse following COVID-19 infection 7% (95% CI 4%-12%). Moreover, the prevalence of pseudo relapse among 4 studies was 5% (95% CI 2%-11%).Conclusion: Our findings demonstrate that the prevalence of MS exacerbation is much higher following COVID-19 infection compared with COVID vaccination. Although there is no strong link between COVID-19 vaccination and MS exacerbation, it is recommended that these patients consult with healthcare professionals to determine the best course of action for their needs.

Keywords

• multiple sclerosis
• covid-19
• vaccination
• acute relapse