Risk of COVID-19 infection in MS and neuromyelitis optica spectrum disorders

By: Moli Fan, MD, PhD, Wei Qiu, MD, PhD, Bitao Bu, MD, PhD, Yan Xu, MD, PhD, Huan Yang, MD, Dehui Huang, MD, Alexander Y. Lau, MD, Jun Guo, MD, PhD, Mei-Ni Zhang, MD, Xinghu Zhang, MD, PhD, Chun-Sheng Yang, MD, PhD, Jingshan Chen, MD, Pei Zheng, MD, Qiang Liu, MD, PhD, Chao Zhang, MD, PhD, and Fu-Dong Shi, MD, PhD

Neurol Neuroimmunol Neuroinflamm 2020;7:e787. doi:10.1212/NXI.0000000000000787 Abstract


Disease-modifying drugs (DMDs) may alter the immune status and thus increase the sus- ceptibility to coronavirus disease 2019 (COVID-19) in patients with MS or neuromyelitis optica spectrum disorders (NMOSD). However, evidence supporting this notion is currently lacking. In this study, we conducted a survey on the risk of COVID-19 in patients with MS and NMOSD.


The survey was conducted through the Chinese Medical Network for Neuroinflammation. Patients in 10 MS centers from 8 cities including Wuhan were included. Information about MS and NMOSD disease duration and the usage of DMDs were collected. Data of suspected cases of COVID-19 were obtained from hospital visits, questionnaires, and patient self-reporting. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was confirmed through clinical evaluation by a panel of experts in conjunction with chest CT and viral RNA detection.


Eight hundred eighty-two of 1,804 (48.89%) patients with MS and 2,129 of 3,060 (69.58%) patients with NMOSD were receiving DMDs. There were no alterations in the patients’ DMD regimen during January 15, 2020, to March 15, 2020, the 3-month period. None of the patients with MS treated with DMDs had COVID-19. However, 2 patients with relapsing NMOSD were diagnosed with COVID-19-related pneumonia. After treatment, both patients recovered from pneumonia and neither patient experienced new attacks due to predisposing SARS-CoV-2 infection in the following 2 months.


No increased risk of COVID-19 infection was observed in patients with MS or NMOSD, irrespective of whether these patients received DMDs. A battery of stringent preventive measures adopted by neurologists to reduce COVID-19 infection in these patients may have contributed to low risk of COVID-19 infection.