Fear of re-infection, relapse, and  anxiety during COVID-19 pandemic  in patients with multiple sclerosis:  A multi-center study

Abdorreza Naser Moghadasi; Saeed Vaheb; Sara Hamtaei-Ghashti; Aysa Shaygannejad; Mozhdeh Askari; Vahid Shaygannejad; Mohmmad Ali Sahraian; Mahsa Ghajarzadeh

doi:10.18502/cjn.v22i2.13332

Abdorreza Naser Moghadasi Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Saeed Vaheb Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Sara Hamtaei-Ghashti Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Aysa Shaygannejad Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Mozhdeh Askari Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Vahid Shaygannejad Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Mohmmad Ali Sahraian Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Mahsa Ghajarzadeh Brain and Spinal Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/cjn.v22i2.13332

Keywords: Multiple Sclerosis; COVID-19; Recurrence

Abstract

Background: Fear of relapse and re-infection during the coronavirus disease 2019 (COVID-19) pandemic can affect people with chronic relapsing diseases, such as multiple sclerosis (MS). We evaluated fear of re-infection, anxiety, and relapse during the COVID-19 pandemic in Iranian people with MS.

Methods: This multicenter, cross-sectional study was performed in the MS clinic of Sina Hospital, Tehran, Iran, and Hakim Private Hospital, Isfahan, Iran, between January and April 2022. We asked the participants to fill out validated Persian versions of Fear of Relapse Scale (FoR), and Beck Anxiety Inventory (BAI) questionnaires and answer a binary question about their fear of getting reinfected with COVID-19. Results were reported as mean ± standard deviation (SD) for continuous variables or frequencies for categorical variables. For continuous variables which did not have a normal distribution, we reported the median and interquartile range (IQR). Spearman correlation coefficient between anxiety score and FoR score was calculated. An independent samples t-test was used to compare continuous variables.

Results: Three hundred and sixty-eight patients participated in this study. The median scores of FoR and BAI were 49.7 and 34.3, respectively. Fifty-three had new relapses in their last infection. Thirty-six percent of the patients had a fear of getting COVID-19 again, and 43% had a fear of relapse during infection. Three hundred and twenty-three had two doses of COVID-19 vaccine; the most frequent type of vaccine was Sinopharm. There was a significant difference between the median FoR scores among patients with and without relapse during the last COVID-19. There was also a significant positive correlation between anxiety score and FoR (r = 0.49, P < 0.001).

Conclusion: More than one-third of enrolled cases had fear of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) re-infection. Patients who experienced exacerbation of symptoms even in the form of relapse or pseudo relapse (possible clinical relapse) had a higher fear of infection.