COVID-19 and Multiple Sclerosis


Selected sections republished from the NMSS “What You Need To Know About Coronavirus (COVID-19)” [CLICK here for full text]
man wearing face mask in a dark room
Are people with MS considered a “higher – risk” group? MS itself does not increase the risk of getting COVID-19, however, certain factors associated with your MS may increase your risk for complications:
  • Chronic medical conditions, such as lung disease, heart disease, diabetes or cancer
  • Significantly restricted mobility, such as needing to spend most of your day seated or in bed
  • Age 60 or older
  • Possibly taking certain disease modifying therapies that deplete immune system cells
Sometimes, the body’s response to infections, including COVID-19, may cause a temporary worsening of MS symptoms. For example, you may have more trouble with fatigue, thinking, mobility, vision or other symptoms. Typically, these symptoms settle down once the infection clears up. If you are experiencing new MS symptoms or have any concerns about any of your MS symptoms please contact your MS healthcare provider. How can I help protect myself and others? There are actions you can take to help prevent the spread of respiratory viruses, including COVID-19. These include:
  • Cover your mouth and nose with a cloth face cover, like a bandana, when you have to go out in public. This is meant to protect other people in case you are infected – but have no symptoms. Do NOT use a facemask meant for a healthcare worker.
  • Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.
  • Avoid touching your eyes, nose, and mouth.
  • Cover your cough or sneeze with a flexed elbow or tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.
  • Practice ‘social distancing’. Social distancing means avoiding gatherings (greater than 10 people) and maintaining distance (approximately 6 feet) from others when possible.
Should healthy people wear masks in public? Research from China and U.S. Hospitals suggests that small viral particles may stay in the air for a period of time after someone with the virus is coughing, sneezing or even breathing or talking in that particular area. The length of time viral particles stay in an area seems to be based upon things such as the amount of virus and the circulation of air in that location. It is unlikely that this occurs during social distancing outdoors as there is adequate air circulation. The CDC is now recommending people cover their faces when in public. Face coverings do not include medical masks, like N95 respirators or surgical masks. Instead, people are encouraged to wear homemade cloth masks like bandanas and scarves. What should I do about my MS disease modifying therapies (DMT) because of COVID-19? There are recommendations about DMTs and COVID-19 coming from multiple individuals, groups and organizations. While each has attempted to provide clarity and sound guidance, differences in the recommendations have created a significant amount of confusion. Decisions regarding disease modifying therapies (DMTs) are made based upon multiple factors, including:
  • Your MS disease course
  • Other medical conditions you may have
  • Allergies to DMTs
  • Other medications that are not compatible with certain DMTs
  • Risks (including infections) vs. benefit of DMT
  • Your values and risk tolerance
The National MS Society, based upon advice from our National Medical Advisory Committee, has developed guidance on the use of DMTs during the COVID-19 pandemic. In addition, we endorse the global advice provided by the MS International Federation (MSIF) – but emphasize that DMT decision making must be individualized and based upon multiple factors, including those listed above. Both the National MS Society DMT guidance and the MSIF global advice are endorsed by the Consortium of MS Centers and the MS Coalition. Should healthy people wear masks in public? Research from China and U.S. Hospitals suggests that small viral particles may stay in the air for a period of time after someone with the virus is coughing, sneezing or even breathing or talking in that particular area. The length of time viral particles stay in an area seems to be based upon things such as the amount of virus and the circulation of air in that location. It is unlikely that this occurs during social distancing outdoors as there is adequate air circulation. The CDC is now recommending people cover their faces when in public. Face coverings do not include medical masks, like N95 respirators or surgical masks. Instead, people are encouraged to wear homemade cloth masks like bandanas and scarves. What should I do about my MS disease modifying therapies (DMT) because of COVID-19? There are recommendations about DMTs and COVID-19 coming from multiple individuals, groups and organizations. While each has attempted to provide clarity and sound guidance, differences in the recommendations have created a significant amount of confusion. Decisions regarding disease modifying therapies (DMTs) are made based upon multiple factors, including:
  • Your MS disease course
  • Other medical conditions you may have
  • Allergies to DMTs
  • Other medications that are not compatible with certain DMTs
  • Risks (including infections) vs. benefit of DMT
  • Your values and risk tolerance
The National MS Society, based upon advice from our National Medical Advisory Committee, has developed guidance on the use of DMTs during the COVID-19 pandemic. In addition, we endorse the global advice provided by the MS International Federation (MSIF) – but emphasize that DMT decision making must be individualized and based upon multiple factors, including those listed above. Both the National MS Society DMT guidance and the MSIF global advice are endorsed by the Consortium of MS Centers and the MS Coalition. Photo by Engin Akyurt on Pexels.com

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