Are People With MS Vulnerable To COVID-19?

The COVID-19 pandemic has changed the lives of many around the world. The aggressive nature of the disease and the number of lives, especially of the vulnerable, the virus has taken has changed the mindset of people and changed the very style of living. Caused by the SARS-CoV-2 virus, COVID-19 has affected people of almost all the ages but has been especially severe on people with existing medical condition. Since the disease is new and not much data is available, there is no treatment on offer as of now aside from the vaccination drive that has been started in some countries, including the United States for emergency purposes.^[1,2]

The COVID-19 affects the respiratory tract primarily but is not limited to that. It can also have neurological manifestations as well. This leads to the question as to whether COVID-19 has any effect on people with a neurological disorder like Multiple Sclerosis^[1,2]

This question arose due to the fact people with MS take immunosuppressants which make the immune system of the body weak and the patient prone to infections. This should make it easy for a virus like SARS-CoV-2 or Coronavirus to infest the body and cause complications and exacerbations of MS.^[1,2] This article highlights whether people with MS are vulnerable to COVID-19 or not.

Although the data is less and not much research has been done, experts feel that having MS does not increase the risk of getting COVID-19 as much as it is for the normal population. However, some people with certain complications of MS which have been mentioned below are quite vulnerable.^[2]

Mobility Issues: It is known that MS causes significant damage to the nerves. This impedes the ability of the body to communicate effectively with the brain. This in turn affects the daily life of the patient, including moving from one place to another. This is seen in people who are in the advanced stage of multiple sclerosis. Now how this increases the chance of getting COVID-19 can be explained in that such people hardly move from one place to another.^[2]

Remaining sedentary and lack of exercise for long periods of time leads to various complications including diabetes and cardiovascular issues. This in turn makes the patient vulnerable to COVID-19. Another fact is that remaining in bed all day causes mucous to get accumulated in the lungs making it difficult to breathe. This leads to complications like aspiration pneumonia which worsens the effects of COVID-19.^[2]

Lung Disorders: Some people with MS develop problems with their lungs in due course of time. This is because the muscles supporting the lungs become weak and the person loses control of these muscles. Once this happens then begins accumulation of mucous and respiratory secretions within the lungs which in time causes aspiration pneumonia. This makes it easier for people to get COVID-19 and have serious complications due to it.^[2]

There are also some medications given for MS that affect the functioning of the lungs and impact the breathing. They make the breathing slow. This also makes it vulnerable for people with MS that have their lungs affected vulnerable to COVID-19.^[2]

Immunosuppressants: People with MS are put on immunosuppressant medications to control the symptoms. Some of these medications make the immune system weak. This makes the patients vulnerable to various infections including COVID-19. However, if proper precautions are taken then there is no need to stop these drugs. This is because stopping the medications will make the symptoms of MS even worse. It is always better to consult with a physician on the safety of the medication or whether to start an alternative.^[2]

The next question is whether COVID-19 is more dangerous for people with MS. The answer to this is there is no current evidence to suggest that COVID-19 is dangerous for people with MS. However people with advanced stage of MS may have a higher risk for complications than those in the early stages. Age also plays a factor here in that people above the age of 50 with MS have higher mortality rate with COVID-19.^[2]

The Center for Disease Control has issued the following guidelines for people with MS to follow. These include^[2]

• Avoid going to the hospital for checkup if that can be avoided and go for virtual consultation.
• Ensure that all necessary medications have been bought well in advance and stocked up to avoid unnecessary visits to the pharmacy or the hospital.
• The person should not go out of the house unless absolutely required and wear a mask and practice social distancing. Also, frequent hand washing for 20 seconds is a must especially after coming in contact with a surface that may be contaminated.
• Ask the physician if there are any other risk factors that need to be looked at to avoid getting infected with COVID-19.^[2]

In conclusion, a person with MS is at the same risk as any other individual for getting COVID-19 if it is in the early stages. The infection only becomes a problem for those above the age of 60 who have complications arising out of MS like breathing problems or mobility issues.^[1,2]

However, COVID-19 is a pandemic and the risk that it poses to the health of people with or without MS should be taken seriously and proper guidelines as given by the CDC should be followed strictly to avoid getting this infection.^[1,2]

It should be noted that people in the high risk group with MS have recovered after getting COVID-19 but prevention is always better than cure and social distancing, unnecessary travels, washing hands frequently, and wearing a mask when going out is a must especially for people with MS to avoid getting COVID-19.^[1,2]

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