The Impact of COVID-19 on Fatigue in Multiple Sclerosis

Although the COVID-19 quarantine required everyone to make lifestyle changes, it may have had especially profound implications for individuals who experience multiple sclerosis (MS)-related fatigue. Individuals with MS who suffer from fatigue are already predisposed to inactivity and social isolation and are at risk of worsening symptoms. The objective of this study was to examine the impact of the COVID-19 national quarantine and related restrictions on the mental, emotional, and physical fatigue in persons with MS in the United States. We conducted a survey open to all adults (> 18 years) with MS within the United States. The survey gathered demographic information and asked how the COVID-19 pandemic impacted their physical, mental, and emotional fatigue. The survey was completed by 600 individuals, 478 with relapsing MS and 122 with progressive MS. There was a significant 2-way interaction for time by fatigue type; both physical and emotional fatigue significantly increased during the pandemic (P < .01) and remained significantly higher after the pandemic than prior to the pandemic (P < .01). Mental fatigue increased significantly during the pandemic (P < .01) and although it remained higher, on average, after the pandemic, it was not significantly different than prepandemic. Individuals with MS experienced increases in physical, mental, and emotional fatigue over the course of the COVID-19 quarantine. Even after the lifting of quarantine restrictions, these levels have not returned to baseline. To adequately address fatigue, it is critical that health care professionals inquire about all types of fatigue in persons with MS.