Exploring the impact of the COVID-19 pandemic on social isolation and mental health in people with MS

Background: People with multiple sclerosis (MS) may be disproportionally impacted by the coronavirus disease of 2019 (COVID-19) as various factors important to their functioning and quality of life are at-risk and/or compromised during the pandemic. In particular, the social distancing and quarantine practice during the pandemic maybe detrimental to MS patients' social and emotional health. Compared with the general popula-tion, MS patients may be under increased social strain and suffer worse health consequences from social isola-tion. To date, there has been no research examining the social consequences of the pandemic on MS patients' emotional and social health. Methods: This is a retrospective longitudinal study of 266 adults with MS who were followed at a large academic medical center in the Midwest. Each participant completed monthly surveys including depression, anxiety, and social health variables. Results: T-Tests shows worse anxiety (95% CI [-5.03,-3.05]; p-value < 0.001), worse depression (95% CI [-2.67,-1.03]; p-value < 0.001), and worse satisfaction with social roles (95% CI [2.37, 3.95]; p-value < 0.001) since the COVID-19 outbreak (March 2020). Social isolation is associated with worse anxiety (95% CI [-8.98,-4.58]; p -value < 0.001) and depression (95% CI [-6.88,-3.24]; p-value < 0.001). However, individuals who had in-person visits before and after the outbreak did not experience any changes in anxiety, depression, or social health. Conclusion: MS patients' anxiety, depression, and social participation worsened during the COVID-19 pandemic. Social isolation is found to be associated with worse anxiety and depression. However, those who attended in -person visits for their MS treatment did not experience negative changes in their emotional or social health. This study highlights the importance of healthcare provider's alertness to MS patients' social health and the interplay between social and emotional health during the COVID-19 pandemic.