Cardiovascular Complications of COVID-19 in Patients With Multiple Sclerosis: A Lesson From Our Experience

Background and Aim: COVID-19 is an emerging threat that could affect the cardiovascular system in the setting of a cytokine storm syndrome. This study examines the cardiac injury associated with COVID-19 in patients with Multiple Sclerosis (MS). Case Presentation: We analyzed 6 cases of MS in association with COVID-19 who underwent cardiac evaluation during their hospitalization. The mean age of our patients was 36.6 years. Two patients had Secondary Progressive MS (SPMS), one patient had Primary Progressive MS (PPMS), and the rest had Relapsing-Remitting MS (RRMS). Our patients were on both immunomodulatory and immunosuppressive Disease-Modifying Therapies (DMTs). None of our patients had a cardiovascular risk factor or developed cardiovascular complications. Their electrocardiogram, echocardiography, and cardiac enzymes were within normal limits. Results: Their mean length of hospitalization was 11.8 days. After a month of follow-up, all patients returned to their baseline neurological status except the one with PPMS and moderate COVID-19, who experienced 0.5 points increase in her expanded disability status scale score. Conclusion: Patients with MS might be at risk of developing severe COVID-19 in which cardiac injury is a crucial complication. There are limited data describing myocarditis associated with COVID-19 in patients with MS. However, our cases revealed no evidence of cardiac injury in patients with MS, even under immunosuppressive DMTs.