Navigating the landscape of COVID-19 for Multiple Sclerosis patients and clinicians

Neurol Neurochir Pol. 2023;57(1):90-100. doi: 10.5603/PJNNS.a2023.0004. Epub 2023 Feb 2.


The purpose of this literature review was to summarise relevant findings regarding the clinical management of multiple sclerosis (MS) in the COVID-19 pandemic, with the focus on patient risks, and the implications of disease-modifying treatment, both on COVID-19 severity and on the response to the SARS-CoV-2 vaccinations. Although MS per se does not seem to put patients at risk for more severe COVID-19, alongside the risk factors known to apply to the general population, progressive disease course, higher disability status, and B-cell depleting therapies may all negatively affect infection severity. The question of COVID-19 sequelae in patients with MS (pwMS) remains unresolved, challenging researchers to further explore this area. The safety profile of COVID-19 vaccinations in pwMS is similar to that of the general population. The efficacy of the vaccination might be affected by B-cell depletion, as well as by S1PR-modulating medications that attenuate humoral responses to the COVID-19 vaccination. Future research should focus on gathering evidence regarding the clinical course of MS following COVID-19 infection and vaccination in larger studies, as well as on establishing the safest and most efficient schedule of COVID-19 vaccination in pwMS on cell-depleting therapies.

Keywords: COVID-19; COVID-19 vaccination; SARS-CoV-2; disease-modifying therapy; multiple sclerosis.

Publication types

  • Review

MeSH terms

  • COVID-19 Vaccines / therapeutic use
  • COVID-19*
  • Disease Progression
  • Humans
  • Multiple Sclerosis* / complications
  • Multiple Sclerosis* / therapy
  • Pandemics
  • SARS-CoV-2


  • COVID-19 Vaccines