Update January 8,2021
I have not updated this in a while because no new findings have come in. Coronavirus infection remains a potentially severe infection, particularly for people with other risk factors such as increased age, disability, high blood pressure, obesity, smoking, and pre-existing lung conditions. The risk for MS is not much different than for the general population, and the disease modifying treatments, thankfully, do not seem to increase bad outcomes. Texas has just exceeded the previous peak numbers of new infections seen in the late summer, and our hospital ICU is filling up again. The major new development is the availability of two effective vaccines, which I would encourage all my patients to get. I added a separate page regarding the vaccines, which I will update as needed.
Last update October 22, 2020
We have been closely monitoring the evolving corona virus epidemic. Our
concern is that the medicines used for treating MS all affect the immune system in some way, and we don’t know to what degree your MS treatment will reduce your ability to respond to an infection with the coronavirus. This update contains information available to us as of October, 2020. There were several
presentations on MS, coronavirus, and the risks of various MS treatments at the
recent ECTRIMS meeting. Many of these reported nationwide registries that include fairly large numbers of patients, up to 1540 cases of coronavirus in MS patients in the Italian series. Increased age and a higher level of disability correlated with increased risk of severe infection. In most of the studies, untreated patients were at highest risk of bad outcome, but this may be because patients off treatment
tend to be older and more disabled. In most of the studies, there was no clear
effect of any of the MS treatments on the severity of infection. The Italian
registry reported increased risk of severe infection in patients on treatment with
Ocrevus or Rituxan, but again these patients may have more severe disability.
The take home messages remain similar to before:
1. There does not appear to be a definite increased risk from any particular MS
medicine, although there is some concern that people on Ocrevus may be
at increased risk.
2. The risk factors for severe infection in MS patients are the same as those
for the general population, with the addition of level of disability increasing
Our best current advice remains consistent. If you are on a disease modifying
treatment for MS, you should continue it. You should carefully follow the
recommendations on social distancing, handwashing, etc. given to people in
general. If you have additional risk factors, such as lung problems or heart
disease or age over 60, you should be particularly careful.
We are now doing about half of our clinic visits by telemedicine, with in person
visits when needed. If you have questions about your particular situation, you
can call and schedule a new telemedicine visit to address those with us. We also
request that you let us know if you do get an infection or are diagnosed with the
This is a rapidly evolving situation, and we will let you know if we get any
information regarding increased risk for any group of MS patients. I plan to
update this page regularly as new information comes in.