Patients with MS not at higher risk for COVID-19 complications; caution still urged
Patients with MS do not appear at higher risk for contracting COVID-19 nor for worsening complications should they contract the virus compared with the general population, according to Dina A. Jacobs, MD.
“This sometimes surprises people living with MS because they are often told that MS is an autoimmune disease, making some believe that it suppresses their immune system, causing them to be at greater risk for infections,” Jacobs, associate director of the Multiple Sclerosis and Related Disorders Center and associate professor of neurology at the Hospital of the University of Pennsylvania, told Healio. “The good news is that these patients are not at greater risk for COVID-19 just by virtue of having MS. However, some patients with MS may be at greater risk for other comorbidities such as diabetes, hypertension, obesity and heart disease because they may be more sedentary and may not be able to exercise due to physical limitations and these medical conditions can increase the risk for COVID-19 complications.”
In keeping with this, results of a study presented at this year’s virtual Annual Meeting of the American Neurological Association showed that key comorbidities associated with hospitalization among a cohort of patients with MS who contracted COVID-19 included cardiovascular conditions, diabetes, hypertension and morbid obesity.
“This is where we see the problems with MS and COVID-19 come into play and this is mostly what physicians worry about in this patient population,” Jacobs said.
Impact on practice
Not much is currently known about the long-term effects of COVID-19, thus, precautions continue across medical institutions to protect patients, including those with MS.
“This has been a fascinating time to observe. I was involved with the clinical care model within the neurology department here at the Hospital of the University of Pennsylvania where we converted our department to telemedicine early-on during the pandemic,” Jacobs said. ““We worried that our patients would not have access to care during the time that we stopped elective in-person care.”
Jacobs explained they closed the in-person clinic and provided patients care through telemedicine.
“There were ‘telemedicine champions’ at our institution who had been providing telemedicine for their patients pre-COVID. So, these champions were able to train those of us who were not as accustomed to telemedicine and within days, our staff was trained properly on providing care via telemedicine, which was remarkable and reassuring for our patients so they could continue to receive much-needed health care.”
Jacobs said she and colleagues also assessed the various medications their patients with MS were taking and found that they were genreally not detrimental to patients’ health regarding complications with COVID-19.
“We assured our patients that with a few exceptions the medications they are taking for their MS are safe and that they do not need to stop taking them,” she said. “We worked cohesively on a statement and sent it out to our patients proactively.”
The ability to provide telemedicine to reach patients safely in their homes has truly been a gift during this unprecedented time in everyone’s lives, Jacobs added. While telemedicine is not a substitute for all in-person care, it can help provide much needed care in appropriate situations.
“With each new challenge during the pandemic, we have had to pivot,” she said. “We have now gone back to providing more in-clinic visits but continue to take the necessary steps to keep our patients and colleagues safe. There is now a concern about the third COVID-19 wave coming and that we are going to have to go back to providing more telemedicine visits for our patients. The good news is that we now know how to handle things this time around.”
‘Rapid-fire’ communication
Staying on top of communication about COVID-19 is important, Jacobs said.
“To do the right thing by our patients, we need to continually be on top of any new data that come out including frequent communication with our colleagues facing the pandemic globally about any new information they may have,” she said. “We need a method of rapid communication with our patients so that we can update them as our knowledge around COVID-19 evolves. We are quite fortunate to have the technology to be able to communicate with our patients in an efficient manner.”
Moreover, continued adherence to the CDC guidelines is critical.
“Wear a mask, keep outside 6 feet of those who are not immediate family or in your ‘bubble’ and wash your hands,” Jacobs said. “We are now seeing more and more people becoming lax with safety measures because they are growing weary of the pandemic. We have to continue to advocate on behalf of our patients and we have to be role models and practice these safety measures ourselves."
Jacobs additionally stressed the importance of vaccination for influenza.
“We need to limit the spread of influenza as best we can so as not to add to the additional pressure hospitals are under to care for patients with COVID-19,” Jacobs said.
Patience is key
Many have ‘hit a wall’ and have given up on practicing social distance or taking COVID-19 precautions, but patience is key, according to Jacobs.
“Please be patient. Hang in there. Things will slowly but surely get better. Do not be discouraged if we have to social distance for a bit longer until we can get everyone vaccinated for COVID-19,” she said. “Until then, we will continue to learn better ways to do things more safely. I am impressed by how many people have pivoted and come up with creative solutions to problems.”
Still, patience and continued adherence to safety measures is crucial, Jacobs added.
“We need to continue to properly wear masks because it is not worth anyone’s life to not wear them. Eye protection helps, too, if in a particularly high-risk environment,” she said. “The strictness of how we do things will slowly peel away and we will start to get more of the things that we enjoy back in our lives, but it will be a slow process. If we do it the right way, we will get there more quickly with fewer lives lost due to COVID-19.”
For more information:
Dina A. Jacobs, MD, can be reached at the Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA, 19104; email: dina.jacobs2@pennmedicine.upenn.edu.