Dr John Corboy: The Jury Is Still Out on COVID-19 Risk for Patients With MS

Patients with multiple sclerosis (MS) may not have an increased risk of contracting coronavirus disease 2019 (COVID-19), but their risks and outcomes are the targets of ongoing investigation, explained John Corboy, MD, professor of neurology, University of Colorado Denver, School of Medicine, and co-director of the Rocky Mountain MS Center at Anschutz Medical Campus.

Transcript

What should patients with MS know about COVID-19?

So far, it appears that there is no increased risk of being exposed to COVID, as far as we know with MS compared to any other condition. The jury’s still out on all of the impacts related to the use of medication as it relates to if you are exposed to SARS-CoV-2 virus.

And there are registries around the world, which are examining outcomes in individuals who have been exposed who have MS and are taking various medications, to try to answer the question as to whether or not this medication or that medication might either benefit you—as might be the case with steroids, which has been proven, or perhaps with interference, which is conjecture and there are studies which are pending. Or perhaps do some of the medications, again perhaps more highly immunosuppressive therapies, put you at risk of a worse outcome, especially the anti-CD20 monoclonal antibodies like ocrelizumab or rituximab?

There is some data from an Italian registry that suggest there might be an increased risk of poor outcome with the coronavirus should you be on ocrelizumab. Data from a French study, which I think is a somewhat better and larger study, show that the 3 things that are most important if you have MS and are exposed to the coronavirus, the 3 things that are most important with regard to your outcomes, are things that are very similar in people who don’t have MS, and [those are] age, obesity, and level of disability.

As we know, older people, especially larger people, and people who are disabled, especially in nursing homes, are very high risk if they’re exposed to the coronavirus, and it looks to be the same with MS patients, so I think the jury’s still out.

But that’s the primary question we're trying to get the answer to, and this will evolve. We’ll get more data over time for more registries and hopefully have an idea. But ultimately, we need a vaccine. That’s likely the best way that we’re going to try and control the coronavirus, and hopefully we’ll have one relatively soon that is safe and effective and durable. So we’ll see how that goes over the course of the next 6 to 12 months.