SARS-CoV-2/COVID-19 in multiple sclerosis patients receiving disease-modifying therapy

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• The COVID-19 pandemic poses significant challenges in neurology, particularly for multiple sclerosis (MS) patients.
• MS patients often have motor disabilities and are treated with immunosuppressive disease-modifying therapies (DMTs), raising concerns about COVID-19 susceptibility and severity.
• Existing data suggest DMT use does not worsen COVID-19 prognosis; however, MS-related motor disability progression is linked to poorer outcomes.

Observation:

• This study presents four cases of relapsing-remitting MS patients who contracted COVID-19 while on DMT (dimethyl fumarate, Interferon β1b, glatiramer acetate).
• All patients experienced mild COVID-19 courses, with neurological symptoms like headache being most frequent.
• One patient on dimethyl fumarate developed lymphopenia.

Findings:

• Current data suggest DMT use in MS patients does not worsen COVID-19 prognosis.
• MS-related motor disability progression, rather than DMT, appears to be a significant factor for negative COVID-19 outcomes.
• Neurological symptoms, particularly headache, were common in MS patients with COVID-19.

Implications:

• Disease-modifying therapies (DMT) may be safe for multiple sclerosis (MS) patients contracting COVID-19.
• Focusing on managing MS motor disability progression is important for improving COVID-19 prognosis in these patients.
• Further research is warranted to fully elucidate the interaction between MS, DMT, and COVID-19.