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Covid-19 Primary Care Resources

Neurological conditions

Guidance on Covid-19 risk to people with neurological conditions, and specific therapies in MS

This information is sourced from the Association of British Neurologists (ABN):

People with neurological conditions should not stop or alter their medication without prior discussion with their neurology team

Risks from Covid-19

  • Patients with conditions that do not affect their swallowing or breathing muscles and in whom the immune system is working normally are not considered to be at increased risk from Covid-19
  • Milder or moderate forms of many of the commoner neurological disorders, such as Parkinson’s disease, multiple sclerosis, epilepsy are not currently considered to confer increased risk, so long as breathing and swallowing muscles are functioning well
  • Advanced disability and comorbidities are risks for death due to Covid-19

Multiple Sclerosis:

Disease-Modifying Therapies (DMTS) in People with MS

  • The effect of DMTS on the risk of Covid-19 infection and disease remains uncertain
  • The ABN’s provisional conclusion is that most DMTS do not confer a significantly increased risk of Covid-19 infection or its complications
  • Drugs with longer duration of effect (eg ocrelizumab, alemtuzumab) may be given at times of low infection rate, but still confer increased risk of infection and Covid-19 disease at a surge of Covid-19 infection months later
  • Patients should be counselled on the effect of a DMT on their individualised risk of Covid-19 disease

If people with MS are unwell with Covid-19

  • People with MS with mild symptoms of Covid-19 should not stop a first line DMT, but infusions (and cladribine administration) should be delayed until symptoms resolve
  • In cases of MS with severe Covid-19 infection the prescribing team should be consulted, who would normally recommend that all injectables and oral medication are stopped and infusions delayed, restarting fingolimod and natalizumab treatment if possible within 8 weeks to avoid rebound MS disease activity
  • People with MS and their doctors should report confirmed Covid-19 infection to the UK MS Register study of Covid-19