Signs and symptoms of Covid‐19 in patients with multiple sclerosis

Background: Clinical outcomes of MS patients affected by Covid-19 have been deeply investigated, but a further analysis on main signs and symptoms and their risk factors still need attention. Objective: The objective of this study is to group together based on similarity and describe the most common signs and symptoms of Covid-19 in MS patients and identify all factors associated with their manifestation. Method: Logistic and linear regression models were run to recognize factors associated to each pooled group of symptoms and to their total number. Results: From March 2020 to November 2021, data were collected from 1354 MS patients with confirmed infection of Covid-19. Ageusia and anosmia was less frequent in older people (OR:0.98; p=0.005) and more in smoker patients (OR:1.39; p=0.049). Smoke was also associated with an increment number of symptoms (OR:1.24; p=0.031); substance abuse (drugs or alcohol); conjunctivitis and rash (OR:5.20; p=0.042), and presence of at least one comorbidity with shortness of tachycardia, or chest pain (OR:1.24; p=0.008). Some DMTs were associated with greater frequencies of certain Covid-19 symptoms (association between anti-CD20 therapies and increment of the number of concomitant symptoms: OR:1.29; p=0.05). Differences in frequencies among three waves were found for flu-like symptoms (G1, p = 0.024), joint or muscle pain (G2, p =0.013), and ageusia and anosmia (G5, p < 0.001). All cases should be referred to variants up to the Delta. Conclusion: Several factors, along with the choice of specific therapeutic approaches might have a different impact on the occurrence of some Covid-19 symptoms.