The COVID-19 pandemic has proven to be especially traumatic for the elderly and those with chronic conditions like MS, according to Kubra Yeni, DNP. “Although previous studies have reported that people with MS (PwMS) do not have a higher incidence of COVID-19 infection, more severe disease, or mortality, PwMS with a high incidence of psychiatric symptoms, such as anxiety and depression, are likely to be greatly affected by the fear of coronavirus,” Dr. Yeni said. “Furthermore, sleep problems caused by changing daily routines and increased stress can also worsen anxiety and depression. Therefore, it is expected that fear, anxiety, loneliness, hopelessness, depression, and sleep problems experienced during the pandemic period can negatively affect the QOL of PwMS.”

For a paper published in Multiple Sclerosis and Related Disorders, Dr. Yeni and colleagues investigated changes in depression, sleep, and QOL during the COVID-19 pandemic, and the relationship between the fear of COVID-19 and these parameters, in PwMS. A total of 89 PwMS and 262 healthy controls (HCs) were included in the cross-sectional study, which compared data collected before the pandemic with data collected online approximately 1 year after the onset of the pandemic. The Fear of COVID-19 Scale, the Worry and Anxiety Questionnaire, the Beck Depression Inventory, the Pittsburgh Sleep Quality Index, and the MS Quality of Life scale were used as data collection tools. Participants had a mean age of 41, 62% were female, and one-half were unemployed.


Social & Psychological Fields Most Affected by COVID-19

In both groups, the researchers found that social (PwMS, 79.8% vs HC, 89.3%) and psychological (PwMS, 61.8% vs HC, 51.9%) fields on the various scales used for data collection were most affected by the COVID-19 pandemic. “Of total patients, 19% reported that the frequency of exacerbations increased during the pandemic,” the study authors wrote. “In the patient group, the fear of coronavirus and the sleep quality were found not to be different from those in control group; however, the anxiety and depression levels were determined to be significantly higher. Compared to the pre-pandemic period, the sleep quality of the patients was seen to be impaired during the pandemic; however, the depression scores were seen not to change.”


Increase in Exacerbations & Difficulty Accessing Medications

Although improvements in energy/vitality and sexual function scale scores were observed, compared with the pre-pandemic period, deterioration in many sub-dimensions of QOL was detected (Table). Multiple regression analysis demonstrated that anxiety, depression, and the sleep problems were predictors of both physical health and the mental health sub-dimensions.

About one-fifth of PwMS reported an increase in exacerbation frequency and almost one-half reported difficulty accessing medications. “Due to the pandemic, difficulties in accessing health professionals and medications increases the psychological burden of patients and their physical health may also be affected, as treatment will remain incomplete,” wrote Dr. Yeni and colleagues, adding that maintaining remote counseling services for patients is particularly important during this period.

The study team concurred that PwMS were psychosocially affected by the COVID-19 pandemic, which had a significant effect on sleep quality, anxiety, and depression. “Possessing patients’ pre-pandemic depression scores allowed us to compare them with the pandemic period, but it was not possible for anxiety,” they noted. “Although this can be considered a limitation, it should be emphasized that PwMS need psychological support at any time. The regression analysis showed that both anxiety and depression have a negative effect on QOL, confirming findings from earlier studies. Since the need has increased during the pandemic period, attempts to protect the mental health of patients will be effective in increasing QOL.”

Dr. Yeni and colleagues concluded that providing psychosocial support to PwMS is imperative during the pandemic. “Using the developing technology for the benefit of patients and ensuring uninterrupted education and counseling services should be one of the first steps taken,” they wrote.