Impact of disease-modifying drugs on the severity of COVID-19 infection in multiple sclerosis patients

J Med Virol. 2021 Mar;93(3):1314-1319. doi: 10.1002/jmv.26593. Epub 2020 Oct 30.


Recent evidence suggested that neurological manifestations occur in patients with a severe form of coronavirus disease (COVID-19). On the basis of this issue, neurologists are very concerned about patients with neurological disorders, especially multiple sclerosis (MS), as consumers of immunosuppressive or immune-modulating drugs. Therefore, the administration of proper disease-modifying therapies (DMTs) in MS patients is critical during the pandemic status. On the one hand, both the autoimmune diseases and immunosuppressive drugs increase the risk of infection due to impairment in the immune system, and on the other hand, postponing of MS treatment has serious consequences on the central nervous system. In the present study, we discussed recent literature about the effect of DMTs administration on the severity of COVID-19 in the MS patients. Overall, it seems that DMTs do not provoke the COVID-19 infection in the MS patients by declining immune responses and cytokine storm. However, as a precaution, the supervision of a neurologist is highly recommended.

Keywords: coronavirus; immune system; nervous system.

Publication types

  • Review

MeSH terms

  • Animals
  • COVID-19 / immunology
  • COVID-19 / pathology*
  • Humans
  • Immunologic Factors / immunology
  • Immunologic Factors / therapeutic use*
  • Immunosuppressive Agents / immunology
  • Immunosuppressive Agents / therapeutic use*
  • Multiple Sclerosis / drug therapy*
  • Multiple Sclerosis / immunology
  • Pandemics / prevention & control
  • SARS-CoV-2 / immunology
  • Severity of Illness Index


  • Immunologic Factors
  • Immunosuppressive Agents