The Multiple Sclerosis International Federation (MSIF) has issued new recommendations about how the coronavirus pandemic might, or might not, impact the lives of people with MS.
The MSIF, a network of national MS societies from around the world, first issued recommendations about COVID-19 and MS last spring. But much has been learned about the virus since then, including how it affects people with MS. The new recommendations address whether MS leads to complications with the virus, and whether it’s advisable to be treated with disease-modifying therapies during the pandemic.
Are people with MS affected differently than healthy people?
According to the MSIF, the answer is apparently not, although there are exceptions.
“The latest data is reassuring that people are not at a greater risk of contracting the virus or developing severe symptoms just because they have MS,” Clare Walton, head of research and access at MSIF, told me in an email.
But the updated recommendations add to the list of those with MS who are thought to have an increased risk of more severe cases of COVID-19. Previously, the list of those at higher risk included people with progressive MS, those with a score of 6 or higher on the Expanded Disability Status Scale, and people over 60. The new recommendations add to that men with MS, Black people and possibly South Asians with MS, people with MS who are obese or have diabetes, and those being treated with some disease-modifying therapies.
DMTs, COVID-19 and MS
An MSIF press release describes one change regarding disease-modifying therapies as “critical.” Some research indicates that DMTs targeting CD20 cells — specifically, Ocrevus (ocrelizumab) and rituximab — appear to be linked to an increased chance of someone with MS being hospitalized or requiring intensive care treatment if infected with the virus.
On the other hand, preliminary evidence indicates that interferons, – such as Avonex (beta 1-a) and Betaseron (beta 1-b) – may reduce the need for hospitalization due to COVID-19.
Tysabri (Natalizumab) has been moved into the group of DMTs considered to have no apparent risks.
Overall, the guidelines still recommend that “people with MS currently taking DMTs continue with their treatment, unless advised to stop by their treating clinician.”
Those who have tested positive for COVID-19, or who have begun to show symptoms, should discuss MS therapies with their healthcare provider, the guidelines state.
General recommendations
We should all be familiar by now with basic COVID-19 advice for the general public, such as the importance of wearing a mask, washing your hands, and social distancing. In terms of the latter, the federation states that people should follow national guidelines in their home countries.
Also, the MSIF states that people receiving high-dose steroids should socially isolate for one month because evidence shows they are at a higher risk of more severe COVID-19.
What about a vaccine?
With the hopeful news that a COVID-19 vaccine could be close at hand, the question arises about whether people with MS should be inoculated. The MSIF recommendations only say there’s not yet enough information about how a vaccine might interact with MS or the various DMTs to be certain. This advice will be included in an update as soon as it becomes available.
I think I’d take a COVID-19 vaccine if approved by health authorities. Would you?
(A version of this post first appeared as my column on the MS News Today website).
(Featured image by ivabalk from Pixabay)
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