How to manage MS during the coronavirus pandemic


The prospect of catching coronavirus is terrifying for everyone, but it’s especially so for anyone already living with an autoimmune disorder or chronic condition.

 

So what does coronavirus mean for MS patients?

We asked five of our most burning MS-coronavirus questions to Dr Gavin Giovannoni, a professor of neurology at Queen Mary University of London and specialist in MS disease-modifying therapies.

Does MS increase my chance of contracting coronavirus?

'Despite many people and information resources answering this question in the affirmative, the answer is we simply don't know,' says Dr Giovannoni.

'To get infected with the COVID-19 coronavirus you have to be exposed to the virus. If you prevent exposure you don't get infected. This COVID-19 virus is spread from one person to another via respiratory droplets produced during coughing and sneezing. Therefore personal hygiene, in particular washing hands, and social distancing and social isolation will reduce your chances of getting COVID-19.'

Will I have a severe reaction if I’m taking immunosuppressant medication?

At the moment, experts believe that lots of people have been exposed to the virus but aren’t showing or developing any symptoms yet.

If you’re taking immunosuppressive therapies, however, you’re more likely to have symptoms if you do come into contact with the virus. However, that doesn’t mean that you’re going to have a more severe case of the disease.

Dr Giovannoni says: ’It appears that severe COVID-19 infection is not necessarily due to the virus, but the immune response to virus. Therefore, paradoxically, it has been hypothesised that immunosuppressed people may be somewhat protected from severe disease.’

But it’s worth pointing out that this is only a hypothesis.

Should I self-isolate because I have MS?

The government has recommended that we all socially-distance ourselves as much as possible, whether you have a pre-existing condition or not. The guidelines recommend self isolation for anyone deemed to be vulnerable, and that includes MS patients.

However, Dr Giovannoni says that he doesn’t believe everyone with MS is vulnerable.

'I think this advice is referring to patients who are severely immunosuppressed, i.e. those who have been treated with specific immune reconstitution therapies (HSCT, alemtuzumab and possibly cladribine) in the last 3-6 months.

'I say 3-6 months because post IRTs your immune system recovers at different rates and this advice probably refers to patients who still have very low lymphocyte counts, i.e. less than 500/mm3.

I personally don't think this advice refers to patients on other DMTs, which may be immunomodulatory or less immunosuppressive.

'Another group this advice refers to is those with advanced MS with swallowing and breathing difficulties. These types of patients will be more vulnerable to secondary lung complications if they did get COVID-19.'

Can coronavirus cause an MS relapse?

Around a third of relapses are caused by vital infections so if you have MS and are not currently receiving a disease-modifying treatment, you may be more susceptible to a relapse should you contract coronavirus.

'However, I suspect if you are on a DMT, in particular a high-efficacy DMT, then COVID-19 won't trigger a relapse,' Dr Giovannoni explains.

Should I avoid attending my hospital appointments?

As with any changes to your treatment, this is something you need to discuss with your MS team. Although you don’t tend to contract the disease in hospitals, hospitals may soon find themselves overwhelmed with coronavirus patients so it’s worth finding out from your MS nurse or consultant exactly what their plan is for you over the next few weeks or months.

Do not miss any appointments without talking to you team first!

For more MS and coronavirus content, check out Dr Giovannoni’s site, MS-Selfie.

Information contained in this Articles page has been written by talkhealth based on available medical evidence. The content however should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands or treatments.

Information written by the talkhealth team

Last revised: 23 March 2020
Next review: 23 March 2023