COVID-19 & MS

Objective

The primary objective of this microsite is collate information from the Barts-MS blog and to answer questions about COVID-19 in relation to multiple sclerosis and its treatments. You can either ask questions on the blog or via the Google form below. We will make every effort to keep up-to-date to help everyone get through the next few months.

Background

  • COVID-19 or coronavirus disease 2019 refers to the infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
  • The disease was first identified in Wuhan, China, and has spread globally, resulting in a COVID-19 pandemic. COVID-19 infection is very non-specific; common symptoms include fever, cough and shortness of breath. Associated flu-like symptoms such as muscle pain, sputum production and sore throat are less common.
  • Please note the COVID-19 refers to corona virus disease due to the SARS-CoV-2 virus that was first identified in 2019.
  • Please note the majority of COVID-19 cases are mild with a small number progressing to severe pneumonia and multi-organ failure. The mortality of COVID-19 is about 3%, but ranges from ~0.2% in those less than 20 years to up to 15% in those over the age of 80 years.
  • Other risk factors for severe COVID-19 infection include male sex, smoking, pre-existing lung disease (e.g. severe asthma), comorbidities, in particular, hypertension and diabetes, and possibly being immunocompromised or suppressed.
  • COVID-19 is spread from one person to another via respiratory droplets produced during coughing and sneezing. Time from exposure to onset of symptoms is generally between 2 and 14 days, with an average of five days.
  • The standard method of diagnosis is by the molecular detection of the virus from a nasopharyngeal or throat swab. A small number of people can present with diarrhoea and the virus can be detected in the stool.
  • Because the virus is an enveloped virus and has a cell-like membrane it is susceptible to detergents. Therefore frequent hand-washing is one way to prevent infection. Hand sanitizers work as well, but need to contain more than 60% alcohol to disrupt the viral envelope.
  • Other preventive measures include maintaining a distance from others, and trying not to touch one's face.
  • The use of face masks is more controversial. Face masks are generally recommended for those who suspect they have the virus and for healthcare workers and carers.
  • At present there is no vaccine or specific antiviral treatment for COVID-19.
  • The management of COVID-19 involves symptomatic therapies, ventilatory and other supportive care and isolation.

For more information please follow the UK Governments website or read the wikipedia entry on Coronavirus disease 2019, which is being kept up-to-date.

Questions

The best way to answer questions for the pwMS that benefits everyone is to curate them on one microsite (MS-Selfie). Most of the questions will come via our Barts-MS Research Blog. The following are examples of the kind of COVID-19 related questions we will try and answer:

NEW QUESTIONS

Will steroids increase my risk of getting COVID-19 or severe COVID-19? (09-April-2020)

Can you do a relapse assessment remotely? (09-April-2020)

Can you treat relapses remotely? (09-April-2020)

Intravenous or oral steroids to treat a relapse? (09-April-2020)

Is it safe to suspend natalizumab (Tysabri) infusions? (03-April-2020)

How does natalizumab extended interval dosing work? (03-April-2020)

How safe is extended interval dosing and does it matter if it is every 6 or 8 weeks? (03-April-2020)

What is a normal lymphocyte count? (30-March-2020)

If I get severe COVID-19 will I be managed in a critical care unit? (30-March-2020)

Risk of COVID-19 Infection

What should I do if I get symptoms suggestive of COVID-19?

Does MS increase my chance of getting COVID-19 infection?

Does MS increase my chance of getting severe COVID-19 infection?

Should I avoid attending my hospital appointments?

Are there any people with MS who have had COVID-19 infection?

Will my immune system be able to fight COVID-19 if I become infected?

Impact of COVID-19 on MS and its management

What if I have a relapse?

Does COVID-19 cause MS to relapse?

Should I self-isolate because I have MS?

Should I take steroids during the COVID-19 pandemic?

What about relapse assessments during the COVID-19 pandemic?

DMTs and COVID-19

Can I postpone or stop my natalizumab infusions?

Should I stop my DMT if I become infected with COVID-19?

What about my blood/urine monitoring; should I suspend monitoring during the epidemic?

What is a safe lymphocyte count?

Am I at increased risk of COVID-19 because I am on a specific DMT?

General information

How does the new Government guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19 impact on me?

Can you recommend a good source of information to keep me updated on COVID-19 infection and MS?