Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
BMC Neurol. 2024 Nov 19;24(1):453. doi: 10.1186/s12883-024-03956-x.
Multiple sclerosis (MS) is a chronic, inflammatory, and demyelinating disease of the central nervous system. The first presentation's possible triggers are still controversial among scientists. The objective of this study is to investigate and compare the potential social, environmental, and physical factors that may have contributed to the onset of MS before and during the Coronavirus Disease 2019 (COVID-19) pandemic.
A questionnaire was designed in the MS research center of Sina Hospital and also distributed as an online Google Form on social media among Iranian MS patients. Demographic information, MS disease-related data, and possible patients reported MS triggers were recorded. They were containing stressful life events, COVID-19 and other infections, COVID-19 and other vaccines, pregnancy or labor, head trauma, surgery, and weight loss. Patients were divided into two groups regarding the time of MS diagnosis (before and during the COVID-19 pandemic).
Of 920 participants, 670 (72.8%) were female, and the mean age ± SD was 35.63 ± 8.1. The majority of patients (69.2%) had non-progressive forms of MS, and only 7.6% needed assistance for ambulation. 69% of participants were diagnosed with MS before the onset of the COVID-19 pandemic. There was a statistically significant difference between the most common first MS symptom before and after the beginning of the pandemic (visual type (n: 317 (49.9%)) before and sensory type (n: 170 (59.6%)) after the COVID-19 pandemic). A stressful life event was the most common patient-reported trigger of MS first presentation in both groups. (56.1% before and 54% after the COVID-19 pandemic). Comparing two groups, economic problems (AOR: 1.81; 95% ACI: 1.23-2.65) and job losses (AOR: 2.89; 95% ACI: 1.37-6.08) were significantly more common triggers for the initial presentation of MS after the pandemic, while the stress of occupational or educational exams (AOR: 0.52; 95% ACI: 0.34-0.79) was more prevalent before the pandemic.
Patients believe that stressful life events are closely linked to triggering their first MS symptoms. Since the beginning of the COVID-19 pandemic, economic problems and job losses have increased; however, occupational or educational exams stress decreased. Caring for social stress by societies may affect MS development or delay MS onset.
多发性硬化症（MS）是一种中枢神经系统的慢性、炎症性和脱髓鞘疾病。第一次发病的可能诱因在科学家之间仍存在争议。本研究的目的是调查和比较可能导致 MS 发病的潜在社会、环境和身体因素，这些因素在 2019 年冠状病毒病（COVID-19）大流行之前和期间可能发挥了作用。
在西那医院的 MS 研究中心设计了一份问卷，并在伊朗 MS 患者的社交媒体上以在线谷歌表格的形式分发。记录了人口统计学信息、MS 疾病相关数据以及患者报告的可能的 MS 诱因。这些诱因包括生活压力事件、COVID-19 和其他感染、COVID-19 和其他疫苗、妊娠或分娩、头部外伤、手术和体重减轻。患者根据 MS 诊断时间（在 COVID-19 大流行之前和期间）分为两组。
在 920 名参与者中，670 名（72.8%）为女性，平均年龄±标准差为 35.63±8.1。大多数患者（69.2%）为非进展性 MS 形式，只有 7.6%需要辅助行走。69%的参与者在 COVID-19 大流行之前被诊断为 MS。在 COVID-19 大流行之前和之后，最常见的首次 MS 症状之间存在统计学显著差异（视觉类型（n：317（49.9%））和感觉类型（n：170（59.6%）））。生活压力事件是两组患者报告的首次 MS 发作的最常见诱因。（COVID-19 大流行前为 56.1%，大流行后为 54%）。比较两组，大流行后经济问题（AOR：1.81；95% ACI：1.23-2.65）和失业（AOR：2.89；95% ACI：1.37-6.08）更常见MS 初始发作的诱因，而职业或教育考试的压力（AOR：0.52；95% ACI：0.34-0.79）在大流行前更为普遍。
患者认为生活压力事件与触发他们的首次 MS 症状密切相关。自 COVID-19 大流行开始以来，经济问题和失业有所增加；然而，职业或教育考试的压力有所减轻。社会对社会压力的关注可能会影响 MS 的发展或延迟 MS 的发病。
