SARS‐CoV‐2 Is Linked to Brain Volume Loss in Multiple Sclerosis

ABSTRACT Objective The impact of SARS‐CoV‐2 infection on brain and spinal cord pathology in patients with multiple sclerosis (pwMS) remains unclear. We aimed to describe changes in brain lesion activity and brain and spinal cord volumes following SARS‐CoV‐2 infection. Methods We included 177 pwMS (5...

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Main Authors: Tomas Uher, Dominika Stastna, Ingrid Menkyova, Vaclav Capek, Jiri Lindner, Petra Nytrova, Jan Krasensky, Eliza Varju, Miguel D'haeseleer, Eva Kubala Havrdova, Dana Horakova, Manuela Vaneckova, Niels Bergsland
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Annals of Clinical and Translational Neurology
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Online Access:https://doi.org/10.1002/acn3.70091
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author Tomas Uher
Dominika Stastna
Ingrid Menkyova
Vaclav Capek
Jiri Lindner
Petra Nytrova
Jan Krasensky
Eliza Varju
Miguel D'haeseleer
Eva Kubala Havrdova
Dana Horakova
Manuela Vaneckova
Niels Bergsland
author_facet Tomas Uher
Dominika Stastna
Ingrid Menkyova
Vaclav Capek
Jiri Lindner
Petra Nytrova
Jan Krasensky
Eliza Varju
Miguel D'haeseleer
Eva Kubala Havrdova
Dana Horakova
Manuela Vaneckova
Niels Bergsland
author_sort Tomas Uher
collection DOAJ
description ABSTRACT Objective The impact of SARS‐CoV‐2 infection on brain and spinal cord pathology in patients with multiple sclerosis (pwMS) remains unclear. We aimed to describe changes in brain lesion activity and brain and spinal cord volumes following SARS‐CoV‐2 infection. Methods We included 177 pwMS (570 MRI scans) diagnosed with and tested positive for SARS‐CoV‐2 infection between August 2020 and May 2021. All patients were free of clinical disease activity, disease‐modifying therapy changes, and corticosteroids during the study. MRI scans were performed using a standardized protocol on a 3‐Tesla scanner. We analyzed the effect of SARS‐CoV‐2 on brain lesion load accrual and brain and spinal cord volume measures using adjusted mixed‐effect models. Results During SARS‐CoV‐2 infection, patients had a median disease duration of 14.2 years, a median age of 44.9 years, and a median Expanded Disability Status Scale of 2.0. SARS‐CoV‐2 infection did not lead to any changes in the number or volume of T1 or T2 lesions in the brain. However, SARS‐CoV‐2 was associated with an increased whole brain (B = −0.17; SE = 0.08; p = 0.028), grey matter (B = −0.25; SE = 0.12; p = 0.040), and cortical grey matter volume loss (B = −0.32; SE = 0.13; p = 0.014). Greater ventricular enlargement following SARS‐CoV‐2 infection was evident only in individuals over the age of 40 (interaction of age vs. ventricular enlargement: B = 0.17; SE = 0.05; p = 0.0003). Only patients with more severe SARS‐CoV‐2 infection showed a reduction in mean upper cervical cord area (MUCCA) (B = 1.14; SE = 0.52; p = 0.030). Interpretation SARS‐CoV‐2 infection in clinically stable pwMS was linked to increased neuronal tissue loss.
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spelling doaj-art-2aac657bd8b84f1698aa26111abbd5b02025-08-20T04:01:48ZengWileyAnnals of Clinical and Translational Neurology2328-95032025-08-011281548155510.1002/acn3.70091SARS‐CoV‐2 Is Linked to Brain Volume Loss in Multiple SclerosisTomas Uher0Dominika Stastna1Ingrid Menkyova2Vaclav Capek3Jiri Lindner4Petra Nytrova5Jan Krasensky6Eliza Varju7Miguel D'haeseleer8Eva Kubala Havrdova9Dana Horakova10Manuela Vaneckova11Niels Bergsland12Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine Charles University in Prague and General University Hospital Prague CzechiaDepartment of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine Charles University in Prague and General University Hospital Prague CzechiaDepartment of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine Charles University in Prague and General University Hospital Prague CzechiaDepartment of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine Charles University in Prague and General University Hospital Prague CzechiaDepartment of Radiology, First Faculty of Medicine Charles University in Prague and General University Hospital Prague CzechiaDepartment of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine Charles University in Prague and General University Hospital Prague CzechiaDepartment of Radiology, First Faculty of Medicine Charles University in Prague and General University Hospital Prague CzechiaDanish Multiple Sclerosis Registry, Department of Neurology Copenhagen University Hospital‐Rigshospitalet Glostrup DenmarkUniversitair Ziekenhuis Brussel (UZ Brussel), Department of Neurology Brussels BelgiumDepartment of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine Charles University in Prague and General University Hospital Prague CzechiaDepartment of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine Charles University in Prague and General University Hospital Prague CzechiaDepartment of Radiology, First Faculty of Medicine Charles University in Prague and General University Hospital Prague CzechiaBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences University at Buffalo, State University of New York Buffalo New York USAABSTRACT Objective The impact of SARS‐CoV‐2 infection on brain and spinal cord pathology in patients with multiple sclerosis (pwMS) remains unclear. We aimed to describe changes in brain lesion activity and brain and spinal cord volumes following SARS‐CoV‐2 infection. Methods We included 177 pwMS (570 MRI scans) diagnosed with and tested positive for SARS‐CoV‐2 infection between August 2020 and May 2021. All patients were free of clinical disease activity, disease‐modifying therapy changes, and corticosteroids during the study. MRI scans were performed using a standardized protocol on a 3‐Tesla scanner. We analyzed the effect of SARS‐CoV‐2 on brain lesion load accrual and brain and spinal cord volume measures using adjusted mixed‐effect models. Results During SARS‐CoV‐2 infection, patients had a median disease duration of 14.2 years, a median age of 44.9 years, and a median Expanded Disability Status Scale of 2.0. SARS‐CoV‐2 infection did not lead to any changes in the number or volume of T1 or T2 lesions in the brain. However, SARS‐CoV‐2 was associated with an increased whole brain (B = −0.17; SE = 0.08; p = 0.028), grey matter (B = −0.25; SE = 0.12; p = 0.040), and cortical grey matter volume loss (B = −0.32; SE = 0.13; p = 0.014). Greater ventricular enlargement following SARS‐CoV‐2 infection was evident only in individuals over the age of 40 (interaction of age vs. ventricular enlargement: B = 0.17; SE = 0.05; p = 0.0003). Only patients with more severe SARS‐CoV‐2 infection showed a reduction in mean upper cervical cord area (MUCCA) (B = 1.14; SE = 0.52; p = 0.030). Interpretation SARS‐CoV‐2 infection in clinically stable pwMS was linked to increased neuronal tissue loss.https://doi.org/10.1002/acn3.70091brain atrophybrain lesionCOVID‐19MRImultiple sclerosisSARS‐CoV‐2
spellingShingle Tomas Uher
Dominika Stastna
Ingrid Menkyova
Vaclav Capek
Jiri Lindner
Petra Nytrova
Jan Krasensky
Eliza Varju
Miguel D'haeseleer
Eva Kubala Havrdova
Dana Horakova
Manuela Vaneckova
Niels Bergsland
SARS‐CoV‐2 Is Linked to Brain Volume Loss in Multiple Sclerosis
Annals of Clinical and Translational Neurology
brain atrophy
brain lesion
COVID‐19
MRI
multiple sclerosis
SARS‐CoV‐2
title SARS‐CoV‐2 Is Linked to Brain Volume Loss in Multiple Sclerosis
title_full SARS‐CoV‐2 Is Linked to Brain Volume Loss in Multiple Sclerosis
title_fullStr SARS‐CoV‐2 Is Linked to Brain Volume Loss in Multiple Sclerosis
title_full_unstemmed SARS‐CoV‐2 Is Linked to Brain Volume Loss in Multiple Sclerosis
title_short SARS‐CoV‐2 Is Linked to Brain Volume Loss in Multiple Sclerosis
title_sort sars cov 2 is linked to brain volume loss in multiple sclerosis
topic brain atrophy
brain lesion
COVID‐19
MRI
multiple sclerosis
SARS‐CoV‐2
url https://doi.org/10.1002/acn3.70091
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