ARE People With MS at Higher Risk for COVID-19?

The possible hazards of MS disease-modifying therapies differ, so treatment decisions must be individualized. 

One thing we seem to hear, see, or read on a daily basis are words like “underlying health condition,” “immune compromised,” and “at-risk population” when the more dire potential outcomes of COVID-19 are discussed.

Many of us assume that those of us with multiple sclerosis (MS) fit into those, and so many other, categories of people who may be particularly susceptible to both the viral disease and its most severe results.

An article, published on March 27 in the journal Multiple Sclerosis and Related Disorders, compiles some of the latest medical thinking about those concerns and relays some unexpected — even hopeful — notes as well.

MS Not the Only Relevant Factor

It is early days as regards the depth of medical knowledge about this novel coronavirus (SARS-CoV-2), but as much of medicine is dealing with nothing else, much is being learned at a quickening pace.

Some considerations may seem obvious if we really think about them, but MS alone isn’t as much of an issue as the effect that MS, along with other aspects of a person’s life, has on our whole lives.

According to the March 27 article, “Other aspects to consider when assessing a respiratory viral infection include: smoking practices (increased cigarette smoking increases risk); ambulatory status (less mobility increases risk, especially if the patient is in a wheelchair); age (increasing age increases risk); weight (increasing weight impacts on ambulation and respiratory function); underlying respiratory illnesses, such as asthma or COPD. Also, the frequency of necessary attendance at a hospital or healthcare facility for laboratory or MRI testing, but also for infusions, may place the patient at a higher risk of exposure.”

Regarding potential exposure to COVID-19 in a healthcare setting, the article advises, “Visits for MS care should preferably be done by telemedicine or phone.”

When it comes to disease-modifying therapies (DMTs) for MS, the article’s lead author, Professor Gavin Giovannoni, MBBS, PhD, of the Blizard Institute at Barts and the London School of Medicine and Dentistry, has charted DMT risk categories to advise doctors about starting and maintaining these drugs in the current pandemic, and even about whether to continue a DMT in the event of COVID-19 infection.

You can see the table by opening the link to the whole article and scrolling to Table 1.

This table is, of course, only a guide for MS practitioners and their patients. The article stipulates that “the potential hazards posed by each DMT differ and, rather than imposing a blanket rule, decisions regarding treatment should be individualized and discussed with patients. For some patients, having their MS treated and controlled may be more important than the potential danger of being exposed to and acquiring a more severe COVID-19 infection.”

Could Some DMTs Be Protective?

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