Differential Diagnosis of Exacerbations and Pseudo-Exacerbations Against the Background of Sars-Cov-2 by the Example of a Clinical Case of a Patient With Multiple Sclerosis

Abstract

Abstract. Due to the COVID-19 pandemic, there is an increasing need for information on how SARS-CoV-2 affects individuals with multiple sclerosis (MS). The patients receiving disease-modifying therapy (DMT) for MS are more likely to require medical attention for infection than the general population. SARS-CoV-2 can cause the worsening of MS symptoms and be mistaken for a relapse, so physicians must carefully assess whether a patient is experiencing a relapse or pseudo-exacerbation. Thus, there is a necessity for science-based guidelines on how to lower the risk of infection, as well as an early differential diagnosis of relapse and pseudo-exacerbation, and effective care for MS patients with COVID-19. Materials and methods of research: a patient with a history of MS treated with DMTs. The patient presented with worsening disease symptoms, likely exacerbation, and was diagnosed with COVID-19. Results: a thorough analysis of existing literature was conducted, along with a quick examination of how DMT was used in MS patients with COVID-19. The patient we dealt with was receiving DMT and experienced a severe illness. Timely use of intravenous corticosteroids and antibiotics allowed taking under control the activity of the pathological process. Fortunately, the outcome was favorable. Conclusions: this evaluation presents information about the clinical features, results, and functions of DMTs in MS patients infected with SARS-CoV-2. Healthcare professionals must carefully consider the possibility of relapse in MS patients with COVID-19, particularly during the pandemic, and should look out for pseudo-exacerbations. While many cases demonstrated a mild course of illness and successful recovery with DMTs, additional investigation is required to create guidelines supported by evidence.