ABSTRACT
Background and aims: The COVID-19 pandemic persisting crisis showed an upheaval on the whole world. People with multiple sclerosis (MS) are a particularly vulnerable group. We aimed to assess how this pandemic has affected MS patients during the lockdown decreed in Tunisia. Methods: After obtaining the approval of ethics committee, a phone survey was conducted from the 15th of May to the 15th of June in the MS center in Razi hospital in Tunis- Tunisia. The designed questionnaire includedin particular the impact of the lockdown on patients' medical follow-up, MS symptoms, treatment availability and daily lifestyle and professional activities. Results: A total of 213 questionnaires were fulfilled. There was no SARS CoV-2 infected case in our cohort. Patients completely followed quarantine guidelines in 176 cases (82.6%). Professional activities were totally stopped in 80.3% while teleworking was adopted in only 4.9% of active patients. During the lockdown, 46 patients (21.6%) experienced a relapse. Steroids were prescribed in 15 cases. Exacerbation of existing symptoms related to MS was described by 133 patients (mainly mood disorders (87%) and sleep disturbances (62%)). About 58 patients interrupted their MS treatments mainly because of mobility issues (n=24) and treatment unavailability (n=27). This was significatively associated with the exacerbation of neuropathic pain (p=0.01)) but not with relapses (p=0.27). Physical activity interruption was associated to the exacerbation of fatigue (p=0.02). Conclusion: COVID-19 lockdown negatively affected our MS patients especially in work, psychological state and MS treatments availability. As a consequence, worsening of MS related symptoms and psychiatric features were described.