**1. Introduction**

The outbreak of novel coronavirus disease (COVID-19), declared by the WHO as a pandemic in March 2020, has had a profound and unprecedented impact upon health and social issues worldwide. Severe restrictions (closing of educational and cultural institutions, limitations to service facilities, recommended social distance) were instituted to mitigate rapid spreading of COVID-19 disease. Healthcare settings have been undergoing massive reorganization, prioritizing management of COVID-19 and providing safety for patients and staff, which resulted in interruption or limitation to certain services. A fear of lifethreatening infection, accompanied by a rapid change in lifestyle and socio-economic problems, undoubtedly has had an adverse impact upon well-being of people throughout many countries.

Multiple sclerosis (MS) is a chronic, immune-mediated disease which affects the central nervous system, leading to its long-lasting and disseminated damage. Demyelinative lesions and axonal loss within brain and spinal cord cause multifocal symptoms and signs

**Citation:** Pokryszko-Dragan, A.; Chojdak-Łukasiewicz, J.; Gruszka, E.; Pawłowski, M.; Pawłowski, T.; Rudkowska-Mytych, A.; Rymaszewska, J.; Budrewicz, S. Burden of COVID-19 Pandemic Perceived by Polish Patients with Multiple Sclerosis. *J. Clin. Med.* **2021**, *10*, 4215. https://doi.org/10.3390/ jcm10184215

Academic Editor: Michele Roccella

Received: 6 September 2021 Accepted: 10 September 2021 Published: 17 September 2021

**Publisher's Note:** MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

**Copyright:** © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

of neurological deficit. People with MS were expected to be particularly affected by the pandemic. Disability and immunocompromised status due to disease-modifying treatment (DMT) were initially considered as predisposing factors for severe course to various forms of therapy and rehabilitation [1,2]. Furthermore, cognitive and mental health problems which often occur in MS population, together with insufficient coping abilities, would make these patients more vulnerable to distress caused by the pandemic [3,4].

In Poland, the lockdown was introduced in March, with the restrictions gradually canceled during the summer months. The statement of experts from Polish Neurological Society, concerning management of MS during the pandemic, was published in March and updated in May [5]. The document included recommendations with regard to prevention and treatment of COVID-19 infection in MS population, safety issues at health care facilities, as well as initiation and continuation of DMT. National MS Society also aimed at providing information and support to the patients and their caregivers. Nevertheless, the pandemic has undoubtedly affected MS population in many aspects. Recognition of this impact from the patients' perspective seemed essential for addressing their needs and effective management of major problems emerging from pandemic consequences [6].

The purpose of the study was to evaluate the burden of the pandemic, perceived by Polish MS patients, including the level of experienced stress and coping strategies. We also aimed at identification of the factors most related to stress and coping, including demographics, MS-related and social issues.
