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The information in this article comes from the MSIF in the UK
COVID-19 is a new illness that can affect your lungs, airways and other organs. It is caused by a novel coronavirus (called SARS-CoV-2) that has spread around the world.
The advice below was developed by MS neurologists and research experts from MSIF’s member organisations. It is based on the emerging evidence for how COVID-19 affects people with multiple sclerosis (MS) and expert opinion. This advice will be reviewed and updated as further evidence about COVID-19 becomes available.
Click here to download the full statement as a PDF, including the list of consulted individuals and organisations.
Advice for people with MS
Current evidence shows that simply having MS does not make you more likely to develop COVID-19 or to become severely ill or die from the infection than the general population. However, the following groups of people with MS are more susceptible to having a severe case of COVID-19:
- People with progressive MS
- People with MS over the age of 60
- Men with MS
- Black people with MS and possibly South Asian people with MS
- People with higher levels of disability (for example, an EDSS score of 6 or above, which relates to needing to use a walking stick)
- People with MS and obesity, diabetes or diseases of the heart or lungs
- People taking certain disease modifying therapies for their MS (see below)
All people with MS are advised to follow World Health Organization guidelines for reducing the risk of infection with COVID-19. People in the higher risk groups should pay particular attention to these measures. We recommend to:
- Practise social distancing by keeping at least 1.5 metres* distance between yourself and others, to reduce your risk of infection when they cough, sneeze or speak. This is particularly important when indoors but applies to being outdoors as well.
- Make wearing a mask a normal part of being around other people and ensure that you are using it correctly by following these instructions.
- Avoid going to crowded places, especially indoors. Where this is not possible, ensure to wear a mask and practise social distancing.
- Wash your hands frequently with soap and water or an alcohol-based hand rub (70% alcohol content is considered most effective).
- Avoid touching your eyes, nose and mouth unless your hands are clean.
- When coughing and sneezing, cover your mouth and nose with a flexed elbow or tissue.
- Clean and disinfect surfaces frequently especially those which are regularly touched.
- Talk to your healthcare provider about optimal care plans, through video consultations or in-person visits where needed. Visits to health clinics and hospitals should not be avoided if they are recommended based on your current health needs.
- Stay active and try to take part in activities that will enhance your mental health and well-being. Physical exercise and social activities that can take place outside and with social distancing are encouraged.
- Get the seasonal flu vaccination where it is available and encourage your family to do the same.
Caregivers and family members who live with, or regularly visit, a person with MS in one of the higher risk groups should also follow these recommendations to reduce the chance of bringing COVID-19 infection into the home.
* (National and international guidelines on physical distancing vary between at least 1 metre and 2 metres. People should consider their national guidance and be aware that these are minimum distances, longer being better.)
Advice regarding disease modifying therapies for MS
Many disease modifying therapies (DMTs) for MS work by suppressing or modifying the immune system. Some MS medications might increase the likelihood of developing complications from COVID-19 but this risk needs to be balanced with the risks of stopping or delaying treatment.
We recommend that people with MS currently taking DMTs continue with their treatment, unless advised to stop by their treating clinician.
People who develop symptoms of COVID-19 or test positive for the infection should discuss their MS therapies with their MS care provider or another healthcare professional who is familiar with their care.
Before starting on any new DMT or changing an existing DMT, people with MS should discuss with their healthcare professional which therapy is the best choice for their individual circumstances. This decision should consider the following information:
- MS disease course and activity
- The risks and benefits normally associated with different treatment options
- Additional risks related to COVID-19, such as:
- The presence of other factors for a more severe case of COVID-19, such as older age, obesity, pre-existing lung or cardiovascular disease, progressive MS, higher risk race/ethnicity etc, as listed above
- The current and anticipated future COVID-19 risk in the local area
- Risk of exposure to COVID-19 due to lifestyle, for example whether they are able to self-isolate or are working in a high-risk environment
- Emerging evidence on the potential interaction between some treatments and COVID-19 severity