Multiple Sclerosis and COVID-19
Published May 6, 2020 • By Camille Dauvergne
Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system. Currently, nearly 1 million adults have MS in the United States. The symptoms are varied: fatigue, optic neuritis, weakness of limbs, balance problems, unexplained pain, etc.
In the context of the current health crisis, is MS a risk factor for complications with COVID-19? Do treatments play a role in coronavirus infection? Can coronavirus make MS worse? We answer your questions!
I have MS, am I more at risk of infection or complications with COVID-19?
The SARS-CoV-2 coronavirus does not appear to worsen MS flares or symptoms. But some people with MS can be at risk of infection if they are taking disease-modifying therapies (DMTs), as immunosuppression therapies. These treatments, like GILENYA or TYSABRI, reduce the immune defenses and make you more vulnerable to infection. Therefore, it is essential to respect social distancing and barrier gestures as closely as possible.
Make sure that you do not stop immunosuppressive therapy or any protocol without consulting your doctor or neurologist first! Your MS could progress and cause complications. Continue to take your medications and consult your neurologist or doctor by phone or teleconsultation.
Can I take corticosteroids to treat flare-ups?
During an episode, you may typically receive high-dose corticosteroid injections over a short period of time (in anti-inflammatory action), such as METHYLPREDNISOLONE. According to Professor Thibault Moreau, head of neurology at Dijon University Hospital, there is no predefined treatment. The choice of corticosteroid injection is evaluated by the doctor and depends on the intensity of the flare-up. During the current health crisis, corticosteroids may be applied orally or by injection and may be given at home rather than in hospital or clinic.
My MS treatment has been stopped because of COVID-19, does this pose a risk for my condition?
For some people, treatment can be temporarily interrupted or postponed in order to reduce the risks of complications of a COVID-19 infection. This can only be done if it does not pose a risk to the progression of your MS. This choice is made on a case-by-case basis with your MS care team.
I think I may have COVID-19 symptoms, what should I do?
If you have a high temperature or a continuous cough, you should stay at home except to get medical care. If you're taking a DMT, you should be able to continue taking it if your symptoms are mild. Do not go to your doctor's office, pharmacy or hospital in person. If you're not in immediate danger but you feel you cannot cope with your symptoms at home or your condition worsens after 7 days, call 911. If you are advised to go to your local hospital, you should inform your MS care team (even if you are not admitted).
Do immunomodulators protect against the “cytokine storm” caused by Sars-CoV-2?
Cytokine storm syndrome (CSS) is a form of systemic inflammatory response that can follow a viral or bacterial infection, an inflammatory disease such as MS or certain gene therapies. This syndrome occurs when white blood cells are activated, creating small inflammatory lesions which release inflammatory cytokines (a type of signaling molecule), which in turn activate more immune cells. A hyper inflammation of this kind can be lethal. It is this phenomenon that is responsible for acute respiratory distress syndromes in patients hospitalized for COVID-19.
In the context of MS, immunomodulators such as COPAXONE, AVONEX and REBIF are administered to regulate these excessive immune responses and reduce the inflammation resulting from damage to the myelin sheath (the insulating layer around nerves). The scientific community is currently examining the usefulness of immunomodulatory molecules to prevent acute respiratory distress syndrome in patients with COVID-19. For the time being, basic MS treatments do not seem to have an influence on this phenomenon.
Is there a specific protocol for people on DMT in the event of hospitalization?
In the case of a severe form of COVID-19 requiring hospitalization, patients living with MS and being treated with DMT benefit from the same protocol. This includes close respiratory monitoring by physicians.
I have MS, can I participate in clinical trials for COVID-19?
Guidance on clinical trials will be different depending on what you are testing. So it is always best to talk to your trial team directly.
How can I continue my physical therapy and other treatments while in self-isolation?
MS is a chronic disease requiring multidisciplinary care. Beyond your consultations with your neurologist for your basic treatments, it is particularly important to continue your follow-up with the other specialists (urologists, ophthalmologists, psychologists, physiotherapists, nurses, speech therapists, etc.) to avoid a decline of your overall condition.
The National MS Society has an extensive list of exercise, stretching and meditation resources on their website - from yoga, to ChairFit, to Pilates and aerobics! And if you need someone to talk to, you can contact the National MS Society's MS Navigators: 1-800-344-4867.
How can I find support on Carenity?
Carenity currently has thousands of patients and relatives of patients affected by MS. On the platform, you can find support from other members of the community. It is important that we help one another especially in this difficult context of the COVID-19 pandemic. Feel free to join in on the discussions below!
- MS and the Coronavirus - How are you handling the pandemic?
- MS and the Coronavirus - When will everything be normal again?
- MS and the Coronavirus: Can we get vaccinated?
- Today I feel... A coronavirus special!
- COVID-19 Lockdown and Sleep: How are you sleeping lately?
- Coronavirus: How to keep busy while social distancing?
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Take care and stay home!
Emission Le magazine de la Santé “Sclérose en plaques et coronavirus” diffusée le 27/04/2020 sur France 5
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