MS and COVID-19
COVID-19 is caused by a novel coronavirus that was first detected in people in China in 2019 and has since spread to other parts of the world. As of 2023, the COVID-19 situation is mostly under control, and many local policies such as the use of masks has been revised. Below are general information on COVID-19 that remains relevant.
Are MS patients at higher risk of getting COVID-19?
Having MS does not increase the chance of contracting COVID-19. However, certain factors associated with MS may increase your risk of complications if you are unfortunately infected, which includes:
- Age 60 or older
- Chronic lung and heart disease, diabetes or cancer
- Significantly restricted mobility, such as being chair or bed-bound most of your day
- Using disease modifying therapies for MS
Should I stop my medications for MS?
No. You should not stop your MS medications without medical advice. Although disease modifying therapies (DMT) for MS will affect the body’s immune system and increase the risk of complications for those infected with COVID-19, stopping DMTs without medical advice would significantly increase the risk of disease relapse, which may lead to unnecessary hospitalization and even the need for high-dose steroid treatment.
There are currently three categories of registered DMT for MS in Hong Kong:
(1) Immunomodulators that generally do not suppress the immune system, and do not increase the risk of infections:
- interferons
- natalizumab
(2) Immunomodulators that restrict the ability of the immune system to respond to infection and may increase the risk of infections:
- dimethyl fumarate
- fingolimod
- ozanimod
- siponimod
- teriflunomide
(3) Immunosuppressants that reconstitute the immune system with prolonged depletion of lymphocytes, which may increase the risk of infections:
- alemtuzumab
- cladribine
- ocrelizumab
- ofatumumab
- rituximab (unregistered)
If you are using DMTs in category (3), you may consult your doctor-in-charge, and discuss the pros and cons of delaying the next treatment course. If you are using DMTs in category (2), or have changed from interferons in category (1) to oral medications in category (2), you should continue your current medication, and avoid switching without medical advice. If you are newly diagnosed with MS and plan to start DMT, you should discuss thoroughly with your doctor-in-charge the pros and cons of the different treatment options.
If you have contracted COVID-19, you should consult your doctor-in-charge on whether it is safe to with-hold your current DMT.
Should I receive the COVID-19 vaccine?
From international and local reports, the use of COVID-19 vaccine is generally safe and effective for people with MS. However, the HKMSS has not conducted any studies to make independent statements or recommendations on the COVID-19 vaccine. We recommend MS patients take reference from the following sources in your decision making:
- MS International Federation (MSIF): https://www.msif.org/news/2020/02/10/the-coronavirus-and-ms-what-you-need-to-know/
- National MS Society: https://www.nationalmssociety.org/coronavirus-covid-19-information/multiple-sclerosis-and-coronavirus/covid-19-vaccine-guidance
- HK Government COVID Vaccine Website: https://www.covidvaccine.gov.hk/en/faq