Answering 8 COVID-19 Questions: Part 2

The National Multiple Sclerosis Society is working with experts across the world to learn more about COVID-19 and how it impacts people living with multiple sclerosis.

The latest findings include MS therapies being studied as possible COVID-19 treatments, the role of inflammation in severe cases and the risk of complications from COVID-19.

MS and COVID-19

What do we know about the risk of COVID-19 in people with MS?
We know a few more things as this pandemic unfolds:

• MS does not appear to increase the risk of COVID-19 or the course of the disease.
• However, people with MS may have other medical conditions, or comorbidities, that can increase risk of a more serious course of COVID-19.
• People with MS who have compromised mobility, such as those unable to walk, may also be at greater risk for complications from COVID-19.

Will my disease modifying therapies (DMTs) put me at risk?
There are no data to indicate that DMTs increase the risk of COVID-19 or the risk for complications. Several registries are collecting information about COVID-19 and MS and that data will be available to help inform treatment decisions. Until then, the National MS Society has guidance for the use of DMTs during the COVID pandemic.

Treating COVID-19

What are some complications of COVID-19?
Some of the more severe complications of COVID-19 are due to inflammation – from the immune system working very hard to fight the infection.

Inflammation is a normal immune response, but sometimes the immune system is unable to stop fighting, and the lungs and other organs can become overwhelmed with excess inflammation. Kind of like having your foot stuck on the accelerator at a very high speed with no brakes – eventually, it can be deadly.

This immune response is known as cytokine storm and has been responsible for many of the deaths associated with COVID-19.

What’s available right now to treat or prevent COVID-19?
There is no treatment authorized or FDA approved for the prevention of COVID-19.

Remdesivir, an antiviral medication, was granted emergency use authorization by the FDA for use in hospitalized patients with COVID-19. Compared to untreated patients, Remdesivir shortened COVID-19 recovery time by 31% in a large clinical trial of patients in the hospital setting.

Earlier, chloroquine and hydroxychloroquine (anti-malarial drugs) were also granted this same emergency use authorization.

Many other medications are under investigation to treat the virus and cytokine storm. Three medications that are or have been used to treat MS are under study as potential treatments for the cytokine storm: methotrexate, interferon beta-1b (Betaseron) and fingolimod (Gilenya). Methotrexate and interferon beta-1b are being tested in combination with antiviral drugs and preliminary study results are promising.

More than 100 vaccines are under study with 3 in early clinical trials. Vaccine development can be a 10- to 20-year process, but researchers are working non-stop to trim that timeline to about 18 months.

Staying at Home

I’m feeling anxious about What’s happened so far in the COVID-19 pandemic?
In December 2019, a cluster of people with pneumonia identified in Wuhan, China were found to be infected with a brand new, or “novel,” coronavirus, subsequently named SARS-COV-2. The virus appeared to originate in bats and like some other coronaviruses, evolved to make the jump to humans. Approximately 5 million people worldwide have been infected with the SARS-COV-2 virus. Across the globe, governments made difficult decisions to “flatten the curve” so that viral spread would be slowed, and healthcare systems could meet the needs of all citizens.

What’s in store as far as stay-at-home orders?
In the US and in many countries, stay-at-home orders are being lifted and the doors of business are gradually re-opening. Some restrictions are still in place and vary in different locations. Scientists worry that a new surge of cases will be the result, while others insist that economies must be allowed to reopen – and all of us are hoping for the best.

Support During This Time 

I’m feeling anxious about everything that’s going on – what can I do?
You may be feeling increased anxiety – about your MS, about COVID-19 about your job, about your parents and children – and many other issues.  Many people are not sleeping or eating well, and normal exercise routines have been disrupted.

If you are feeling increased anxiety or depression, contact your primary care provider or your MS provider. Inform your providers right away about symptoms you believe may be related to COVID-19; or related to your MS; or questions about your DMT. 

Try to eat a healthy diet, take your vitamin D if recommended and keep moving.

Where can I find more information, resources and support?
The National MS Society is here for you!

• Contact an MS Navigator for guidance with employment issues and helping finding resources.
• Check out our Ask an MS Expert series to learn more about topics such as COVID in minority populations, exercising at home and treating MS during this time
• Visit our Coronavirus Resources Page to find the latest information  

Until we have more testing, better treatments, better ability to track cases and effective vaccines, infection prevention is of utmost importance. While municipalities are re-opening – the virus is not gone, so:

• Wear a mask/facial covering when out and about
• Avoid crowds
• Maintain social distancing
• Wash your hands frequently

Editor’s Note: Read part 1and part 3 of answering your questions about COVID-19.