Can COVID-19 cause MS? Can eating a MARS bar cause MS?

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The paper reports on someone developing MS like symptoms 2-3 weeks after symptom onset for COVID-19 They say…..

“SARS-CoV-2 infection can produce neurological features. The most common are headache, anosmia and dysgeusia but patients may also develop other central nervous system (CNS) injuries.

We present a patient affected by Covid-19 who initially consulted for decreased visual acuity. The MRI showed inflammation in the right optic nerve and demyelinating lesions in the CNS.

We speculate that an immune mechanism induced by SARS-CoV-2, which can activate lymphocytes and an inflammatory response, plays a role in the clinical onset of the disease. This pathogen may be associated with either the triggering or the exacerbation of inflammatory/demyelinating disease”.

I think I will start to write my next paper…can a Mars bar cause MS? It’s as plausible as this. Statistically it is bound to happen that someone will develop MS, after they have eaten a Marsbar. This may be the first case of MS after COVID, but if it is not the last, it will be a question of who believes this? By the time they were tested there was no virus to be seen but they were positive for anti-COVID antibodies and also had oligoclonal bands.

However if true it rather throws away all the stuff about the MS prodrome (grumbling MS years before it shows itself), the function of the migration studies, the American service studies after BV infection and begs the question of why JC virus is not a cause of MS as it seems far more plausible. We can go on an on and we can have a good old book shredding exercise. We have to wait until a pattern emerges to determine whethet this is exploitism of not.

There have been a number of case reports linking COVID-19

The Emerging Spectrum of COVID-19 Neurology: Clinical, Radiological and Laboratory Findings. Brain. 2020 Jul 8;awaa240. doi: 10.1093/brain/awaa240. Online ahead of print

There were quite a few cases at the National Hospital Queen Square

Five major categories emerged:

(i) encephalopathies (n = 10) with delirium/psychosis and no distinct MRI or CSF abnormalities, and with 9/10 making a full or partial recovery with supportive care only;

(ii) inflammatory CNS syndromes (n = 12) including encephalitis (n = 2, para- or post-infectious), acute disseminated encephalomyelitis (n = 9), with haemorrhage in five, necrosis in one, and myelitis in two, and isolated myelitis (n = 1). Of these, 10 were treated with corticosteroids, and three of these patients also received intravenous immunoglobulin; one made a full recovery, 10 of 12 made a partial recovery, and one patient died;

(iii) ischaemic strokes (n = 8) associated with a pro-thrombotic state (four with pulmonary thromboembolism), one of whom died;

(iv) peripheral neurological disorders (n = 8), seven with Guillain-Barré syndrome, one with brachial plexopathy, six of eight making a partial and ongoing recovery;

Guillain-Barré syndrome is known to develop following viral infection

(v) miscellaneous central disorders who did not fit these categories. SARS-CoV-2 infection is associated with a wide spectrum of neurological syndromes affecting the whole neuraxis, including the cerebral vasculature and, in some cases, responding to immunotherapies. The high incidence of acute disseminated encephalomyelitis, particularly with haemorrhagic change, is striking. This complication was not related to the severity of the respiratory COVID-19 disease.

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12 comments

  • But it all adds to the fear and uncertainty about the future, including the future of the world. Perhaps, as has been said, we with MS are better prepared because we face uncertainty on a daily basis. It’s good to read the latest news but I find that it’s also necessary at times to put the blinkers on and concentrate on the NOW.

  • Have the people with MS who developed covid-19 had really bad relapses?
    Would steroid treatment be advised as soon as someone with MS is diagnosed as having covid-19?

    • I dont think so, because early use may block the protective immune response that stops severe covid from happening

      • If you are on a DMT and stop when you get COVID, it is normally gone before your drugs where of and you can start DMT and no relapse. There are case repots of this scenario published, but simple answer is I dont know

  • What I’d like to know is whether the means of infection with COVID-19 alters the outcome. We know that high viral load at point of infection can make things worse I believe, but is there a difference between someone who breathes in virus and someone who catches it by sticking a contaminated finger in their eye?

  • “I think I will start to write my next paper…can a Mars bar cause MS? It’s as plausible as this. Statistically it is bound to happen that someone will develop MS, after they have eaten a Marsbar. This may be the first case of MS after COVID, but if it is not the last, it will be a question of who believes this? By the time they were tested there was no virus to be seen but they were positive for anti-COVID antibodies and also had oligoclonal bands.”

    That’s a very dangerous mindset.

    Sure, coincidences do happen, but denying or ridiculing a connection from the start just because some observations suggest otherwise can hinder further research. Better to keep an open mind, than to dismiss something just because it doesn’t fit the puzzle right now.

    EBV might be the catalyst for MS, but it surely isn’t the only cause. COVID-19 seems to be neuroinvasive. It’s not too far fetched, to see how this could lead to long term aftereffect.

    This is the most convincing theory I’ve read so far:
    https://www.cell.com/action/showPdf?pii=S1471-4914%2819%2930294-1

    IF the basic premise is correct (even if the details are not 100% right), than every infection, including COVID-19 can lead to MS in some individuals.

    The bigger problem here is something else: Why are researchers so quick to deny a connection between infection and neurological disease? I wouldn’t be surprised if research finds out sometime in the future, that ALS, Alzheimers etc. are symptoms of chronic infections.

    • Dear Koral
      I am dangerous after all I am danger mouse:-). How do you want your news Doom and Gloom/Fraser style from Dads Army…”we’re Doomed” or the light hearted COVId-Breakfast sytle? That I chose to use the COVID breakfast style is not unusual. If you don’t get it, it suggests you are not a regular reader and you will not have been exposed to my mindset….Count yourslef lucky some will say. However, the news is delivered makes no difference. The point is that any neurologist or nurse who reads the blog is aware of this information and that it gets a light-hearted twist they are more likely to remember it and report it if it occurs.

      Last week in the UK, we had the news that there were neurological cases associated with COVID 19. A load of case reports were published in a Journal that doesnt normally publish case reports in a journal where the editor came from the same place as the authors:-(. Anybody who reads knew about this months ago. Indeed when the Association of British Neurologist said that SAR-CoV-2 did not get into the brain, we immediately questoned this.

      In fact, I have been passing on details of neurological cases to our neuros for a number of months. NDG has told me “What’s the news here” she had 3-4 cases ages ago in the first few weeks of infection and if she hadn’t have been so busy could have the first case reports months ago. As a vascular issue one expects problems all over the body and including the bran and we know that the virus can get in the brain and that many people get encephalitis.

      Now there have been 13,000,000 infected for a disease that has been raging for over 6 months and lets say that is 26,000,000 infected for a disease as we know the testing has not been uniformly great and we have this one case report. In Scotalnd we have MS central with 18,000 infected so lets say that is 50,000 infected as the UK testing has been rubbish, means that there will be 50,000 people that are SH1 scared that they are going to give MS to their children and their loved ones, if the “News of the Screws” tabloid media pick this story up.

      Why are researchers quick to respond…well you may know that this blog was set up precisely because researchers are not quick to respond! Any quack can take over the Social media space and set up a conspiracy theory, even a president can do it. However, as a consequence of saying nothing the MS community became at war with itself, neurologist were demonised for being non-believers and the MS Societies poured millions into doing CCSVI research going no-where. If I am wrong and COVID-19 causes MS then lots of research money will be coming our way:-)

      The most convincing theory…you have read should have been mine:-)…it’s simpler than the Pender idea but thanks for this link I missed it when it came out in March, I was too busy reading about COVID-19. But if it makes MS show itself from scratch quicker than an upper respiratory tract infection can cause a relapse in someone already with MS, we should be seeing an avalanche of MS as COVID-19 has swept through the MS at-risk Anglo Saxon/Viking origin countries and as the UK is country with a significant ethnic contingent who are particularly susceptable to COVID-19, maybe ProfG will comment if they have been deluged with new MS cases. We (Royal London Hospital) had I think the second highest death rate of COVID-19 in the UK and serve on of the most affected populations in the UK. So we were a COVID hotspot. Aree we making a mountain out of a molehill or is it the begining of a volcano? If it is a volcano forming you can be sure I will happily report it, but won’t guarentee you will get it in a Doom and Gloom style. However it is important that we keep things in perspective otherwise we will be soiling our pants every time we hear the COVID-19 news. 🙂

      P.S. To critise us for not accepting that an infection is a route cause of MS…I think is a bit harsh…Please search on “Black Swan”

      P.P.S. Remember it could have been me that reviewed and accepted the paper because of my open mindedness

  • I had covid first week in February, I was coughing for 4 months. I was never tested, but in aftersight… I have been tired ever since, thought I was depressed. went to ARNP he diagnosed me with OCD, ADHD and depression… gave me meds.. 5 weeks into meds I got really bad headaches, and a few days later I had severe pain in my left eye and partial vision loss. I have never ever been really sick, they now suspect MS and Ill be in for further investigation. I think you are on to something with this.

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