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. 2020 Sep;26(10):1163-1171.
doi: 10.1177/1352458520948231. Epub 2020 Aug 10.

Multiple sclerosis management during the COVID-19 pandemic

Affiliations

Multiple sclerosis management during the COVID-19 pandemic

Brandon P Moss et al. Mult Scler. 2020 Sep.

Abstract

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.

Keywords: COVID-19; SARS-CoV-2; disease modifying therapies; health behaviors; healthcare delivery; multiple sclerosis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Ms B.A. has nothing to disclose. Dr G.A. has received compensation for consulting services or participation in advisory boards from Sanofi, Merck, and Roche; research support from Novartis; travel expenses for scientific meetings from Novartis, Roche, Stendhal, and ECTRIMS; speaking honoraria from Sanofi and Merck; and is a member of the International Women in Multiple Sclerosis (iWiMS) network executive committee. https://orcid.org/0000-0002-2657-5510. Dr R.A.B. has served as a consultant for Biogen, EMD Serono, Genzyme/Sanofi, Genentech/Roche, Novartis, and Viela Bio. He receives ongoing research support directed to his institution from Biogen, Genentech, and Novartis. Mr P.C.-M.’s yearly salary is supported by a grant from Biogen to Fundació privada CEMCAT toward statistical analysis, and he has received travel expenses from Biogen. Dr S.C.-R. is an ECTRIMS clinical fellowship awardee; he has received travel expenses for scientific meetings from Biogen Idec and Genzyme, compensation for consulting services or participation in advisory boards from Roche and Novartis, and speaking honoraria from Novartis. https://orcid.org/0000-0002-7612-3985. Dr J.A.C. received personal compensation for consulting for Adamas, Convelo, MedDay, and Mylan; and serving as an editor of Multiple Sclerosis Journal. Ms M.D. has nothing to disclose. Dr K.C.F. is supported by NIMH K01 MH121582 and a Career Transition Fellowship from the National MS Society. Ms K.H. has nothing to disclose. Dr L.H.H. has received speaking and consulting fees from Biogen, Genzyme, Genentech, Novartis, Bristol Myers Squibb, and EMD Serono. Mr T.H. has nothing to disclose. Mr S.H. has nothing to disclose. Dr K.R.M. is funded by NIH NINDS K23 Career Development Award 1K23NS109328. Dr M.P.M. has served on scientific advisory boards for Genzyme and Genentech, research support from Novartis, and receives funding from a KL2 (KL2TR002547) grant from Clinical and Translational Science Collaborative of Cleveland, from the National Center for Advancing Translational Sciences (NCATS) component of the NIH. Dr X.M. received speaking honoraria and travel expenses for scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past 3 years with Actelion, Alexion, Bayer, Biogen, Celgene, EMD Serono, EXCEMED, Genzyme, MedDay, Merck, MSIF, Nervgen, NMSS, Novartis, Roche, Sanofi-Genzyme, Teva Pharmaceuticals, and TG Therapeutics. https://orcid.org/0000-0002-0098-9918. Dr B.P.M. reports research funding for investigator-initiated studies from Roche and is site PI for studies sponsored by Roche; he received speaking fees from Genzyme, consulting fees for Roche, and has stock in Pfizer. Dr E.L.M. reports research funding for investigator-initiated studies from Biogen, Sanofi-Genzyme, and Teva, and is site PI for studies sponsored by Biogen. She received royalties for editorial duties for UpToDate. Ms E.O. has nothing to disclose. Dr D.O. has received research support from the National Institutes of Health, National Multiple Sclerosis Society, Patient Centered Outcomes Research Institute, Race to Erase MS Foundation, Genentech, Genzyme, and Novartis. He has also received consulting fees from Biogen Idec, Genentech/Roche, Genzyme, Novartis, and Merck. Ms M.R.-B. has nothing to disclose. Dr J.S.-G. has received compensation for participating on Advisory Boards, speaking honoraria and travel expenses for scientific meetings, consulting services or research support from Celgene, Novartis, Biogen, Teva, Merck, Almirall, and Genzyme. https://orcid.org/0000-0002-1589-2254. Dr P.T. is an ECTRIMS clinical fellowship awardee and has received travel expenses for scientific meetings from Roche. https://orcid.org/0000-0002-4048-7314. Dr M.T. has received compensation for consulting services and speaking honoraria from Almirall, Bayer Schering Pharma, Biogen Idec, Genzyme, Merck-Serono, Novartis, Roche, Sanofi-Aventis, and Teva Pharmaceuticals. Dr M.T. is coeditor of Multiple Sclerosis Journal—Experimental, Translational and Clinical. https://orcid.org/0000-0001-9999-5359. Ms Z.W. has nothing to disclose. Ms M.W. has nothing to disclose. Dr A.Z. has received travel expenses for scientific meetings from Biogen Idec, Novartis, and Genzyme; speaking honoraria from Eisai; and a study grant from Novartis. https://orcid.org/0000-0003-3860-5251.

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