ABSTRACT
Introduction: Personal social networks impact the quality of life of people living with multiple sclerosis (pwMS). Objective / Aims: To evaluate the dynamic associations between personal network features and neurological function in pwMS and control participants during the COVID-19 pandemic and compare with the pre-pandemic period. Method(s): We first analyzed data collected from 8 cohorts of pwMS and control participants during the COVID-19 pandemic from March-December 2020. We then leveraged data collected between 2017-2019 in 3 of the 8 cohorts for longitudinal comparison. Participants completed a personal network questionnaire, which quantified the structure and composition of each person's personal network, including the health behaviors of network members. Neurological disability was quantified by three interrelated patient-reported outcomes: Patient Determined Disease Steps (PDDS), Multiple Sclerosis Rating Scale-Revised (MSRS-R), and Patient Reported Outcomes Measurement Information System (PROMIS)-Physical Function. We identified the network features associated with neurologic disability using paired t-tests and covariate-adjusted regressions. Result(s): In the cross-sectional analysis of the pandemic data from 1130 pwMS and 1250 control participants, percentage of network members perceived to have a negative health influence was associated with greater neurological symptom burden in pwMS (MSRS-R: Beta[95% CI]=2.181[1.082, 3.279], p<.001) and worse physical function in control participants (PROMIS-Physical Function: Beta[95% CI]=-5.707[-7.405, -4.010], p<.001). In the longitudinal analysis of 230 pwMS and 136 control participants, the percentage of people contacted weekly or less (p<.001) decreased during the COVID-19 pandemic for both pwMS (0.30+/-0.26 v. 0.19+/-0.22) and controls (0.23+/-0.25 v. 0.15+/-0.21) when compared to the pre-pandemic period. PwMS further experienced a greater reduction in network size (p<.001), increase in constraint (a measure of close ties of the network, p<.001) and decrease in maximum degree (highest number of ties of a network member, p<.001) than controls during the COVID-19 pandemic. These changes in network features were not associated with worsening neurological disability. Conclusion(s): Our findings suggest that negative health influences in personal networks are associated with worse disability in all participants and COVID-19 pandemic led to contraction of personal networks to a greater extent for pwMS than controls.