Impact of COVID-19 on Multiple Sclerosis Management

While research on the long-term effects of the pandemic on the health of patients with multiple sclerosis (MS) remains ongoing, study authors found most patients with MS do not need major revisions to their treatment plan due to risk of COVID-19.

“However, individuals who are older, more disabled, and on more potent therapies may need to consider strategies for decreasing their overall risk,” wrote researchers.

According to study authors, increasing age, male sex, cardiopulmonary comorbidities, higher disability level, and a progressive disease course are risk factors for a more severe course of COVID-19 among patients with MS.

A retrospective cohort study that included 56 patients with MS who contracted COVID-19 showed an increase relapse rate in patients with MS does not appear to be correlated to COVID-19 infection or subsequent hospitalization.

Most patients with MS already using a disease modifying therapy (DMT) were instructed to continue taking it, but researchers reported that individualized approached to DMT decisions are necessary.

“This should include an assessment of overall risk based on factors such as the patient’s age, comorbidities, exposure risk, the burden of treatment monitoring, and disability level in addition to the potential risk incurred by DMT,” wrote study authors. “Especially for those on natalizumab or [Sphingosine-1-phosphate] receptor modulators, due to the potential for rebound events, the risk of stopping a DMT may outweigh the potential benefit.”

While decision-making for neurologists and patients becomes increasingly difficult, a connection between MS and severity or mortality from COVID-19 was not observed.

“Regardless, continued improvement in our understanding of interactions between infections, disease-modifying therapy, and MS are paramount to optimizing the care of those with MS going forward,” concluded study authors.

Reference:
Hollen C, Bernard J. Multiple Sclerosis management during the COVID-19 pandemic. Curr Neurol Neurosci Rep. 2022; 22(8):537-543. doi:10.1007/s11910-022-01211-9.