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The authors of this review summarized current literature regarding multiple sclerosis immunotherapies and risks of SARS-CoV-2. They propose new guidelines for continuation of treatments in the presence of coronavirus, taking into account the mechanism of immunosuppression in light of recent discoveries regarding the immune response to the coronavirus.
Providers may consider these data in addition to published guidelines when making treatment decisions for individual patients.
– Kyle Binder, MD
This abstract is available on the publisher's site.
A major concern during the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic1 is the use of immunosuppressive therapies for the treatment of multiple sclerosis (MS) due to an increased risk of contracting SARS-CoV-2 and more severe disease. The Society of Italian Neurologists (SIN) and the Association of British Neurologists (ABN) MS and Neuroimmunology Advisory Group published guidance for the use of current disease modifying treatments (DMTs) in MS (Table 1)2. However, taking into account, less conservative viewpoints3, the emerging knowledge of the biology of SARS-CoV-2, and in particular the role of the immune mechanisms contributing to the disease, we propose modification of these guidelines since it is not clear that immunosuppression is indeed detrimental in people with MS infected with SARS-CoV-2. We are thus proposing a more nuanced approach and that the categories of DMTs should be modified based on scientific principles and the biology of severe COVID-19.