Update of COVID-19 and MS – Morbidity and mortality figures

Schedule

• Presentation of a UK COVID-19 case by Prof Richard Nicholas
• Update the MS community on the preliminary results of the UK MS Register study
• Presentation of the Italian experience of managing MS during the pandemic by Prof Marco Salvetti
• Open Q&A with all panellists

CPD acceditation

This webinar has been approved by the Federation of the Royal Colleges of Physicians of the United Kingdom for 1 category 1 (external) CPD credit(s). To claim the credit please email hughskelton@neurologyacademy.org

Presentation slides

Overview of case scenarios discussion from webinar

Much of the webinar reviewed data on morbidity and mortality figures, and the slides provide a good summary overview of what was said.

Prof Richard Nicholas presented on behalf of the MS Register team and provided an overview of the impact of disease-modifying therapies (DMTs) during the early phase of the COVID-19 pandemic.

Key conclusions to note include:

• DMTs do not appear to be associated with increased risk of infection from COVID-19
• Younger age is associated with a higher risk of COVID-19
• Having progressive MS and self-isolating for two weeks are associated with a lower risk of infection from COVID-19.

(He presents from the start of the video until 11.39 minutes.)

Prof Marco Salvetti presented an Italian project on MS and COVID-19 run by the Italian Neurological Society and the Italian MS Society. The study evaluated increased / decreased risk of COVID-19 associated with DMTs and has long term goals of assessing risk factors for more severe outcomes from COVID-19.

(He presents from 11.39 until 23.46 minutes.)

Between 23.46 and 50.00, the three panelists respond to questions from the live webinar audience, and discuss their thoughts around the data currently presented.

Prof Gavin Giovannoni provided four fictitious case scenarios based around questions that have been posed over the recent webinars which are shown in his slides. However, due to the complexity of them, he chose to discuss the first scenario only with the panel.

Key comments from this case scenario 1 are:

• Richard suggested he would go ahead with redosing with alemtuzumab in this circumstance.
• He would recommend self-isolation and support trying to work from home as much as possible initially.
• Gavin added that this self-isolation should be in place, as far as possible, for the first 3 months, and then, if tests are ok, she could continue with social distancing and sensible living.
• Regarding the vaccine, once patients have resumed a normal lymphocyte count, they are safe to have a vaccine, so it would be based on the timeframes, once her count has returned to a safe level.

(This discussion was from 50.00-55.27 minutes.)

The remainder of the webinar addressed questions including:

• When can we recommence clinical trials? (55.27-59.11)
• What are your thoughts on paediatric MS at the moment, and treating children with MS with fingolimod during the pandemic? (59.11-59.57)
• Can you add suspected patients with COVID-19 to the MS registry? And do you think patients who seem to have recovered from COVID-19 still need to isolate if lymphocyte counts remain low? (1.00.00-1.02.52)
• Discussion on vaccines and learning from working through a pandemic (1.02.52-1.06.00)

Useful links

• UK MS Register study:
  • ukmsregister.org/coronavirus
  • Case report form for HCPs
• Study MuSC-19: musc-19.dibris.unige.it
• Prof Gavin Giovannoni’s microsite MS-Selfie (Q&As and case studies):
  sites.google.com/giovannoni.net/clinicspeak-dmt/covid-19-ms