Coronavirus and Multiple Sclerosis

I was somewhat reluctant to write an article on this topic, as the situation is currently very vague and circumstances change daily. On the other hand, it is understandable that MS patients in particular want to receive specific information about their situation beyond general information – and therefore a comment on DocBlog is certainly useful and timely.

However, I would like to point out that I can only express my personal views here, which I try to execute to the best of my knowledge, but which are not backed by scientific studies due to the current events.

It is currently assumed that an infection with the new corona virus (COVID-19) poses a potential danger and we should all do our best to contain the infection routes as much as possible. Therefore, the sometimes drastic measures such as the blockade of certain regions in northern Italy or curfews in North Rhine-Westphalia make sense, because the main aim is to gain time for the development of therapy/vaccine development.

On the other hand, it is quite likely – as the Federal Minister of Health made clear at his press conference last Wednesday – that due to the complexity of the infection routes, it will no longer be possible to control them completely and Europe is at the beginning of the Corona virus epidemic. Experts estimate that 15% of infections are severe and up to 1% can be fatal. However, it is unclear what data these figures are based on. The Robert Koch Institute (RKI) currently estimates the risk to the health of the population in Germany as low to moderate.

The corona virus causes respiratory symptoms such as cough, cold, sore throat and fever, some sufferers also have diarrhoea. Similar to an infection with the flu virus, it seems that especially older patients with chronic pre-existing conditions of the lungs or the cardiovascular system are particularly at risk.

Multiple sclerosis (MS) is also a chronic disease, but it is not a risk factor for a severe course of a corona virus infection. To make it clear once again – MS is not an immune deficiency, on the contrary, the immune system works too well and leads to autoimmunity. Moreover, many MS patients are young and healthy apart from MS. Therefore, I would not assess the risk of an MS patient differently than the risk of the normal German population.

Many MS patients have the problem that they take medications that change the function of their immune system – and of course a lot of questions arise in connection with the new corona virus. There are currently no hard data on this topic, so we can only speculate on the basis of what we know about the substances.

In my opinion, patients who use an interferon preparation or Copaxone do not need to worry. With all other preparations that interfere with cellular immunity, a slight (usually not significant compared to placebo) increase in upper respiratory tract infections was observed within the licensing studies. Now we have a lot of experience from the last few years with various flu waves and can therefore also estimate the effects on MS patients under medication – with the difference, of course, that there is currently no vaccination prophylaxis against the corona virus. Therefore, we can state that the flu waves did not have catastrophic effects on MS patients under immunomodulatory therapy – so there is no reason to panic now.

However, I would recommend all patients under immunomodulatory therapy to follow the measures for infection prophylaxis. This includes keeping away from people with cold symptoms, good hand disinfection and also avoiding large events/crowds. Wearing a face mask in public is not necessary, it rather suggests pseudo-security. I would also strongly advise against stopping or delaying the intake of MS medication – this is not advisable in any case in terms of benefit-risk analysis.

Given that there are people in our population who have a higher risk potential due to a disease or medication, it is even more important that we all – the entire German population – remain vigilant and prudent and try to break the chains of infection to the best of our knowledge. We should all remember to disinfect our hands, stay at home with cold symptoms or avoid large events/crowds. We are all responsible!

In a time like this, a little social slowdown would probably do very well – just dive under the Corona wave, which will pass at some point.

 

 

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