Infection, Relapses, and Pseudo-Relapses in Individuals With Multiple Sclerosis.

IF 2.3 Q3 CLINICAL NEUROLOGY

Neurology. Clinical practice Pub Date : 2025-08-01 Epub Date: 2025-06-04 DOI:10.1212/CPJ.0000000000200493

Amber Salter, Samantha Lancia, Mudita Sharma, Gary R Cutter, Robert J Fox, Ruth Ann Marrie

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引用次数: 0

Abstract

Background and objectives: Infections are associated with an increased risk of relapse and pseudo-relapse in persons with multiple sclerosis (MS). However, the relationship with relapses and pseudo-relapses after SARS-CoV-2 infections (COVID) vs other infections in MS is poorly understood. Therefore, we compared the occurrence of relapse and pseudo-relapse after COVID and other infections with noninfected participants with MS.

Methods: In spring 2023, we surveyed participants from the North American Research Committee on Multiple Sclerosis Registry regarding whether they had had a COVID infection, other infections, relapses, and pseudo-relapses. Recent infections, occurring in the 6 months before the survey, were used to categorize participants into groups: recent COVID, non-COVID infection (with no history of ever having COVID), COVID and non-COVID infections, or uninfected.

Results: Of the 4,787 participants eligible for analysis, 2,927 participants were included, of whom 294 (10%) had a recent COVID infection; 853 (29.1%) had 1 recent infection other than COVID; 246 (8.4%) had a recent COVID and non-COVID infection; and 1,534 (52.4%) had no infection with COVID nor any infection within the past 6 months (uninfected). Compared with no infections, non-COVID infection was associated with a 39% increased likelihood of relapse (1.39, 95% CI [1.04-1.87]), whereas a recent COVID infection was associated with a decreased likelihood of relapse (0.45 [0.23, 0.87]), adjusting for covariates. All infection groups were associated with increased odds of pseudo-relapse compared with the uninfected group (non-COVID infections: 1.78 [1.44, 2.20]; COVID infection: 1.80 [1.32, 2.45]; COVID and non-COVID infection: 3.04 [2.24, 4.12]).

Discussion: Because individuals with MS are at increased risk of infections, the association of infections with relapses and pseudo-relapses is clinically important. The high prevalence of acute worsening after infection, regardless of the type of infection, compared with those with no reported infection, needs to be considered in the management of persons with MS.

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多发性硬化症患者的感染、复发和假性复发。

背景和目的：感染与多发性硬化症（MS）患者复发和假性复发的风险增加有关。然而，MS中SARS-CoV-2感染（COVID）与其他感染后复发和伪复发的关系尚不清楚。因此，我们比较了未感染ms的参与者在COVID和其他感染后的复发和伪复发的发生率。方法：在2023年春季，我们调查了北美多发性硬化症研究委员会登记处的参与者是否有过COVID感染、其他感染、复发和伪复发。在调查前6个月内发生的近期感染，用于将参与者分为以下几组：近期感染COVID，非COVID感染（没有感染过COVID的历史），COVID和非COVID感染或未感染。结果：在符合分析条件的4,787名参与者中，包括2,927名参与者，其中294名（10%）最近感染了COVID；853例（29.1%）近期有1次非新冠感染；近期感染和非感染246例（8.4%）；1534例（52.4%）未感染或6个月内未感染（未感染）。与未感染相比，未感染COVID与复发可能性增加39%相关（1.39,95% CI[1.04-1.87]），而最近感染COVID与复发可能性降低相关（0.45[0.23,0.87]），调整协变量。与未感染组相比，所有感染组的假复发几率均增加(非covid感染：1.78 [1.44,2.20]；COVID感染：1.80 [1.32,2.45]；新冠肺炎和非新冠肺炎感染：3.04[2.24,4.12])。讨论：由于多发性硬化症患者感染的风险增加，因此感染与复发和假性复发的关联在临床上具有重要意义。无论感染类型如何，与未报告感染的患者相比，感染后急性恶化的高患病率需要在MS患者的管理中加以考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurology. Clinical practice CLINICAL NEUROLOGY-

CiteScore

4.00

自引率

0.00%

发文量

期刊介绍： Neurology® Genetics is an online open access journal publishing peer-reviewed reports in the field of neurogenetics. The journal publishes original articles in all areas of neurogenetics including rare and common genetic variations, genotype-phenotype correlations, outlier phenotypes as a result of mutations in known disease genes, and genetic variations with a putative link to diseases. Articles include studies reporting on genetic disease risk, pharmacogenomics, and results of gene-based clinical trials (viral, ASO, etc.). Genetically engineered model systems are not a primary focus of Neurology® Genetics, but studies using model systems for treatment trials, including well-powered studies reporting negative results, are welcome.