tetano
Editor, Senior Moderator
J Neurol Sci
. 2025 May 29:475:123552.
doi: 10.1016/j.jns.2025.123552. Online ahead of print. Impact of brain volume on coronavirus disease of 2019 severity and subsequent cognitive decline in patients with multiple sclerosis
Jens Devogelaere[SUP] 1 [/SUP], Ann Van Remoortel[SUP] 2 [/SUP], Delphine Van Laethem[SUP] 3 [/SUP], Laetitia Della Faille[SUP] 2 [/SUP], Marie B D'hooghe[SUP] 1 [/SUP], Jeroen Van Schependom[SUP] 4 [/SUP], Dominika Stastna[SUP] 5 [/SUP], Tomas Uher[SUP] 5 [/SUP], Guy Nagels[SUP] 6 [/SUP], Miguel D'Haeseleer[SUP] 7 [/SUP]
Affiliations
Background: Clinical disability is among the risk factors of a more severe coronavirus disease of 2019 (COVID-19) course in patients with multiple sclerosis (PwMS), but might provide an insensitive reflection of actual tissue pathology. Brain volume loss has emerged as a magnetic resonance imaging (MRI) proxy of neurodegeneration in PwMS. Our main objective was to investigate whether brain volume predicts COVID-19 severity in PwMS.
Methods: Clinical data of PwMS followed at the Belgian National Multiple Sclerosis (MS) Center in Melsbroek are collected in a local database in case of COVID-19 diagnosis. One hundred ninety-eight unique PwMS with a suitable 3D brain MRI available, conducted maximally 24 months before their COVID-19 infection, were included.
Results: An unfavorable outcome due to COVID-19 was noted in fourteen PwMS (hospitalization: 7.1 %, death: 0.5 %). Neither global nor regional normalized brain volumes predicted COVID-19 severity. Similar results were obtained in patients fulfilling the criteria for benign MS. Being unprotected by vaccination was the only variable significantly associated with a poor COVID-19 outcome (OR 3.7; CI 1.2-10.2). We observed a significant worsening of Symbol Digit Modality Test performance in PwMS with the lowest (Q4) whole brain volume, as compared to those with the highest (Q1) (2.2 ± 8.5 versus -1.2 ± 9.1; P = 0.037).
Conclusion: Brain volume does not predict COVID-19 outcome in PwMS, including those with benign MS. Unvaccinated individuals remain susceptible to developing a more severe infection. PwMS with the most profound pre-existing brain atrophy may be at risk for cognitive deterioration after COVID-19.
Keywords: Brain volume loss; COVID-19; Multiple sclerosis; Outcome; SDMT.
. 2025 May 29:475:123552.
doi: 10.1016/j.jns.2025.123552. Online ahead of print. Impact of brain volume on coronavirus disease of 2019 severity and subsequent cognitive decline in patients with multiple sclerosis
Jens Devogelaere[SUP] 1 [/SUP], Ann Van Remoortel[SUP] 2 [/SUP], Delphine Van Laethem[SUP] 3 [/SUP], Laetitia Della Faille[SUP] 2 [/SUP], Marie B D'hooghe[SUP] 1 [/SUP], Jeroen Van Schependom[SUP] 4 [/SUP], Dominika Stastna[SUP] 5 [/SUP], Tomas Uher[SUP] 5 [/SUP], Guy Nagels[SUP] 6 [/SUP], Miguel D'Haeseleer[SUP] 7 [/SUP]
Affiliations
- PMID: 40483742
- DOI: 10.1016/j.jns.2025.123552
Background: Clinical disability is among the risk factors of a more severe coronavirus disease of 2019 (COVID-19) course in patients with multiple sclerosis (PwMS), but might provide an insensitive reflection of actual tissue pathology. Brain volume loss has emerged as a magnetic resonance imaging (MRI) proxy of neurodegeneration in PwMS. Our main objective was to investigate whether brain volume predicts COVID-19 severity in PwMS.
Methods: Clinical data of PwMS followed at the Belgian National Multiple Sclerosis (MS) Center in Melsbroek are collected in a local database in case of COVID-19 diagnosis. One hundred ninety-eight unique PwMS with a suitable 3D brain MRI available, conducted maximally 24 months before their COVID-19 infection, were included.
Results: An unfavorable outcome due to COVID-19 was noted in fourteen PwMS (hospitalization: 7.1 %, death: 0.5 %). Neither global nor regional normalized brain volumes predicted COVID-19 severity. Similar results were obtained in patients fulfilling the criteria for benign MS. Being unprotected by vaccination was the only variable significantly associated with a poor COVID-19 outcome (OR 3.7; CI 1.2-10.2). We observed a significant worsening of Symbol Digit Modality Test performance in PwMS with the lowest (Q4) whole brain volume, as compared to those with the highest (Q1) (2.2 ± 8.5 versus -1.2 ± 9.1; P = 0.037).
Conclusion: Brain volume does not predict COVID-19 outcome in PwMS, including those with benign MS. Unvaccinated individuals remain susceptible to developing a more severe infection. PwMS with the most profound pre-existing brain atrophy may be at risk for cognitive deterioration after COVID-19.
Keywords: Brain volume loss; COVID-19; Multiple sclerosis; Outcome; SDMT.