Correlates of patient reported quality of life in a large multiple sclerosis cohort encompassing the COVID-19 pandemic period

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BACKGROUND: Despite the importance of patient reported outcome measures (PROMs) as a complementary measure of disease burden in Multiple Sclerosis (MS), larger studies examining PROMs and their correlates over time, especially during the COVID-19 pandemic, are rare. OBJECTIVE: To examine the effect of the COVID-19 pandemic, along with demographic and MS disease characteristics, on Multiple Sclerosis Impact Scale (MSIS-29) and Fatigue Scale for Motor and Cognitive Functions (FSMC) scores. METHODS: Cohort study comprising 1,213 individuals enrolled in the prospective COMBAT-MS study, contributing 8,371 and 7,798 MSIS-29 and FSMC questionnaires, respectively. A generalized estimating equation model was applied for the relationship between questionnaire scores and covariates. RESULTS: Questionnaires administered during and after COVID showed somewhat higher FSMC scores compared to the pre-pandemic period. No significant association was found between MSIS-29 scores and the questionnaire period. Expanded Disability Status Scale (EDSS) score was the strongest covariate positively associated with all subdomains of the questionnaires. Male sex was negatively associated with MSIS-29 psychological and FSMC scores. CONCLUSION: EDSS was the strongest predictor of both MSIS-29 and FSMC scores, while the COVID-19 pandemic exerted only limited impact. Findings underscore the importance of preventing accrual of disability to preserve quality of life in MS.

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