Multiple Sclerosis and Covid-19

What you need to know

Covid-19 has been a part of our lives for a long time now. Caused by the virus ‘SARS-CoV-2’, it first appeared in late 2019 and quickly spread around the world. For most people who become infected with Covid-19, symptoms include cough, fever, muscle aches, loss of sense of smell and taste, difficulty breathing, sore throat, feeling tired, and headaches. These symptoms usually get better on their own, within a few days or weeks.

But for some people, especially those living with a chronic condition such as diabetes, hypertension, or heart disease, the symptoms can be much worse. The virus can cause a severe respiratory infection which can make breathing difficult, with some people needing the help of a respirator.

Multiple sclerosis, or MS, is a chronic condition, so you may be worried about the risk that the Covid-19 virus poses to your health. We answer some of the most common concerns people living with MS might have.

I have MS – am I at greater risk of catching Covid-19?

People with MS have exactly the same risk of catching Covid-19, and becoming infected with it, as the general population.

However, those who are severely affected by MS, such as those who have difficulty swallowing, who have progressive MS, who are bedbound or are over the age of 60, as well as people with MS and other conditions such as obesity, may be at greater risk of complications from Covid-19.

MS patients who are taking disease modifying drugs to treat their MS, may also be at an increased risk of infection (see below). These medications work to suppress the immune system and can therefore expose you to a slightly higher risk of infection, including Covid-19. However, it is very important that you do not stop taking any medication prescribed for you. Always talk to your doctor or MS nurse if you are concerned about the risk.

What are the risks associated with Covid19 for people living with MS?

Researchers in Italy have been exploring the effects of Covid-19 on MS patients and have found that people with the condition who contracted the virus did not have a worse outcome compared to the general population.

Covid-19, as with many other infections, can sometimes cause a fever. This can temporarily worsen MS symptoms. However, once the infection is cleared, the MS symptoms usually return as before. A severe Covid-19 infection could also potentially trigger a relapse. For these reasons, doctors recommend that people living with MS should take extra precautions to avoid the infection.

What can I do to protect myself from Covid-19?

Anyone with MS, including those who have received the vaccine, should take extra precautions to protect themselves from Covid-19. Precautionary measures include:

• Social distancing (keeping at least 2 meters distance between yourself and other people)
• Hand hygiene (regular hand washing with soap and water or using hand sanitizer)
• Avoid touching your eyes, nose, or mouth
• Wearing a face mask in public places
• Avoid crowded places, especially indoors
• Avoid large social activities, events, or gatherings
• Consider working from home, if possible
• Keep indoor areas well ventilated
• Clean and disinfect surfaces frequently
• Stay active and try to take part in activities that will enhance mental health and overall wellbeing

Your caregivers, friends, and family members who you live with, or who regularly visit, must also follow these recommendations.

I am taking disease modifying drugs for MS (DMDs) – what should I do?

Most DMDs do not significantly increase the risk of Covid-19 symptoms or the complications associated with the virus. Don’t stop taking any medication that has been prescribed for you and if you have any concerns about the risk, always discuss it with your MS care team.

• Plegridy, Avonex, Rebif, Copaxone, Aubagio, and Tecfidera: These drugs do not increase the risk of serious Covid-19 infection.
• Gilenya: This medicine can increase the risk of viral infections, but so far there is no evidence to suggest worst outcomes in those who contract Covid-19.
• Tysabri: A highly effective DMD, Tysabri has the lowest risk of causing a severe infection with Covid-19.
• Ocrevus: There is some evidence to suggest that people taking Ocrevus may be more likely to be hospitalised and need intensive care if they are infected with Covid-19. Anyone taking Ocrevus should therefore take extra precautions to prevent infections.
• Mavenclad: There is limited evidence to assess the risk of Covid-19 in patients who are taking this drug. The risk of severe Covid-19 infection is likely to be increased for a few months after treatment, so patients should take extra precautions.
• Lemtrada: Again, there isn’t enough evidence to assess the risk of severe Covid-19 infection with this medicine, but as it is a strong immunosuppressant, the risk of Covid-19 may be higher, and patients should isolate for at least 4 weeks after each infusion.

What should I do if I catch Covid-19?

Always contact your MS care team immediately if you have any Covid-19 symptoms. They will always be on hand to talk through any concerns or questions you may have. Don’t stop taking any MS medication you may be prescribed and talk to your doctor about what you should do.

Can I get the Covid-19 vaccine if I have MS?

People with MS should receive the Covid-19 vaccine. This includes the Sinopharm, AstraZeneca, and Pfizer vaccines available in the UAE. As none of these vaccines contain a live virus, there is no risk of infection. Research shows that the vaccines are not likely to trigger an MS relapse, or have any impact on long-term disease progression. Common side effects from the vaccine include fever and body aches, which can make MS symptoms temporarily worse.

In general, the risks of COVID-19 far outweigh any potential risks from the vaccine. Based on data from previous studies of other vaccines and DMDs, having the Covid-19 vaccine is safe. It is important that family members of people with MS and anyone they live with should receive the vaccine as well.

Your MS care team are always available to talk to you, should you have concerns about Covid-19, or anything else related to your condition.