key: cord-0736949-w8ppn17q authors: Mantero, Vittorio; Abate, Lucia; Salmaggi, Andrea; Cordano, Christian title: Multiple sclerosis and COVID‐19: How could therapeutic scenarios change during the pandemic? date: 2021-01-22 journal: J Med Virol DOI: 10.1002/jmv.26796 sha: 84e46c54d0166d42866397096c9d43bbf1a6ba22 doc_id: 736949 cord_uid: w8ppn17q We read with great interest the review by Rostami Mansoor and Ghasemi-Kasman entitled "Impact of disease-modifying drugs on the severity of COVID-19 infection in multiple sclerosis patients" on your journal. This article is protected by copyright. All rights reserved. Ghasemi-Kasman entitled "Impact of disease-modifying drugs on the severity of coronavirus disease 2019 (COVID- 19) infection in multiple sclerosis patients" in your journal. 1 After examining the papers published on this topic, they conclude that it seems that diseasemodifying drugs (DMTs) do not confer an increased risk or provoke COVID-19 infection in multiple sclerosis (MS) patients. In this commentary, we want to focus the attention on the mod- More recently, Giovannoni et al. 16 affirmed that it is essential to consider the potential risk of morbidity and possible mortality for each MS patient, pondering the individual's multifactorial risk profile. Any decision to initiate a DMT during the COVID-19 pandemic will need to be made carefully, considering the COVID-19 pandemic status. However, they suggested suspending a dose of alemtuzumab and assessing anti-CD20 and cladribine risk, considering suspending dosing. Hamdy and colleagues suggested that, in patients with active COVID-19 infection, it is mandatory to stop all DMTs, and the timing of resuming treatment is not well defined. 17 In a recent work by the Italian MS group, a large majority of deaths occurred in patients with advanced disease and disability due to MS, and anti-CD20 treatment was associated with a higher risk of developing COVID-19 symptoms and severe COVID-19 course, with an association with treatment duration. Moreover, methylprednisolone in the month preceding COVID-19 infection was significantly associated with a worse disease outcome. 18 Even Safavi et al. 19 Impact of diseasemodifying drugs on severity of COVID-19 infection in multiple sclerosis patients COVID-19 in teriflunomide-treated patients with multiple sclerosis COVID-19 in dimethyl fumarate-treated patients with multiple sclerosis Mild COVID-19 infection in a group of teriflunomide-treated patients with multiple sclerosis Severe COVID-19 infection in a patient with multiple sclerosis treated with fingolimod COVID-19 infection in a patient with multiple sclerosis treated with fingolimod COVID-19 occurring during natalizumab treatment: a case report in a patient with extended interval dosing approach COVID-19 in a MS patient treated with ocrelizumab: does immunosuppression have a protective role? Alemtuzumab in multiple sclerosis during the COVID-19 pandemic: a mild uncomplicated infection despite intense immunosuppression Mild COVID-19 infection in a patient with multiple sclerosis and severe depletion of T-lymphocyte subsets due to alemtuzumab COVID-19 and multiple sclerosis: a description of two cases on alemtuzumab COVID-19 pneumonia in a multiple sclerosis patient with severe lymphopenia due to recent cladribine treatment Mild or no COVID-19 symptoms in cladribine-treated multiple sclerosis: two cases and implications for clinical practice Infection-related health care utilization among people with and without multiple sclerosis Treating multiple sclerosis and neuromyelitis optica spectrum disorder during the COVID-19 pandemic The COVID-19 pandemic and the use of MS diseasemodifying therapies Managing diseasemodifying therapies and breakthrough activity in multiple sclerosis patients during the COVID-19 pandemic: toward an optimized approach Musc-19 Study Group, et al. Disease Modifying Therapies and COVID-19 Severity in Multiple Sclerosis B-cell depleting therapies may affect susceptibility to acute respiratory illness among patients with multiple sclerosis during the early COVID-19 epidemic in Iran COVID-19 in persons with multiple sclerosis treated with ocrelizumab-a pharmacovigilance case series Assessing the susceptibility to acute respiratory illness COVID-19-related in a cohort of multiple sclerosis patients Multiple sclerosis and COVID-19: How could therapeutic scenarios change during the pandemic?