Multiple sclerosis management during the COVID-19 pandemic

Brandon P. Moss*, Kedar R. Mahajan, Robert A. Bermel, Kelsey Hellisz, Le H. Hua, Timothy Hudec, Scott Husak, Marisa P. McGinley, Daniel Ontaneda, Zhini Wang, Malory Weber, Paula Tagliani, Simón Cárdenas-Robledo, Ana Zabalza, Georgina Arrambide, Pere Carbonell-Mirabent, Marta Rodríguez-Barranco, Jaume Sastre-Garriga, Mar Tintore, Xavier MontalbanMorgan Douglas, Esther Ogbuokiri, Berna Aravidis, Jeffrey A. Cohen, Ellen M. Mowry, Kathryn C. Fitzgerald

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

44 Citations (Scopus)


Background: People with multiple sclerosis (MS) may be at higher risk for complications from the 2019 coronavirus (COVID-19) pandemic due to use of immunomodulatory disease modifying therapies (DMTs) and greater need for medical services. Objectives: To evaluate risk factors for COVID-19 susceptibility and describe the pandemic’s impact on healthcare delivery. Methods: Surveys sent to MS patients at Cleveland Clinic, Johns Hopkins, and Vall d’Hebron-Centre d’Esclerosi Múltiple de Catalunya in April and May 2020 collected information about comorbidities, DMTs, exposures, COVID-19 testing/outcomes, health behaviors, and disruptions to MS care. Results: There were 3028/10,816 responders. Suspected or confirmed COVID-19 cases were more likely to have a known COVID-19 contact (odds ratio (OR): 4.38; 95% confidence interval (CI): 1.04, 18.54). In multivariable-adjusted models, people who were younger, had to work on site, had a lower education level, and resided in socioeconomically disadvantaged areas were less likely to follow social distancing guidelines. 4.4% reported changes to therapy plans, primarily delays in infusions, and 15.5% a disruption to rehabilitative services. Conclusion: Younger people with lower socioeconomic status required to work on site may be at higher exposure risk and are potential targets for educational intervention and work restrictions to limit exposure. Providers should be mindful of potential infusion delays and MS care disruption.

Original languageEnglish
Pages (from-to)1163-1171
Number of pages9
JournalMultiple Sclerosis Journal
Issue number10
Publication statusPublished - 1 Sept 2020


  • COVID-19
  • SARS-CoV-2
  • disease modifying therapies
  • health behaviors
  • healthcare delivery
  • multiple sclerosis


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