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EFFECTS OF MULTIPLE SCLEROSIS ON COVID 19
Lets meet Sam. Sam is a 40 year old patient who had been diagnosed with Multiple Sclerosis. Multiple Sclerosis is an autoimmune disorder. It is a chronic disease of the central-nervous system. Here the body starts attacking itself by mistake. The immune system attacks the nerve fibers, thereby damaging them and causing communication issues between your brain and the rest of your body. This may causes varying ranges of disabilities depending on the extent of damage.
Sam was diagnosed with MS at the young age of 5. His symptoms included numbness in the limbs, lack of co-ordination, vision issues like blurry vision, fatigue, slurred speech etc. His MS was determined to be in the category of relapsing multiple sclerosis, i.e., he may not have continuous issues, but sporadic episodes of symptoms. MS can also be in the progressive category where your symptoms gradually get worse and ultimately affect the quality of life. An early diagnosis helped Sam to get his life on track. He was put on disease modifying therapies (DMT). DMTs are therapies that can alter the course of MS, by reducing the chances of relapses, decrease disease activity and accumulation of systems that hinder our day-to-day activities. With proper treatment Sam was able to have a quality life with at par with his peers with relapses occurring only at times.
Now comes the year 2020 and with it COVID. Just like everyone else Sam was also scared and unsure. He knew that he may be more at risk than others due to his medical conditions. Being on DMTs meant that he was on immuno-suppressants, which inherently weakened his immune system. He felt his risk factors were at an increased level. He also had hypertension. After consultation with his doctors, he decided he would stop his medicines. The doctors advised self-isolation till his immune system replenished. He felt he would do alright. But a couple of months after stopping his medications he found his symptoms returning. Even though he did not have any severe disabilities, he knew that his symptoms were taking a toll on him and his remission period was ending. He started getting more and more episodes, which had been only few-and-far between earlier. In the meantime, he also tested COVID positive. But luckily his symptoms were mild and he was able to make a full recovery due to timely testing. But he had a long journey ahead of him to get his MS back on track.
In the past couple of weeks, we as a team spent time studying the effects of COVID on multiple sclerosis patients. We tried to put to use the tools provided by data-analytics to draw some findings which could help people like Sam and his doctors make informed and data-driven decisions on handling the situation better and provide adequate care for the more vulnerable group. We used a subset of the de-identified data which was open-sourced by GDSI(MS Global Data Sharing Initiative) and published online. The dataset contained data entered both by MS patients or their representatives and clinicians. It was predominantly female patients and also patients in the relapsing-remitting category. Many of them had other co morbidities also like hypertension, lung disease, immunodeficiency, diabetes etc., which further complicated their condition. We also had mostly younger people in the set, i.e., in the age-group of 18-50. Fatigue, dry cough and pain were the most common COVID symptoms seen among MS patients. On analysis we found some interesting aspects.
· The infection rate and hospitalization rate among patients MS patients were only 5.26% and 1.31% respectively, indicating that MS patients are not at a higher risk of contracting COVID than the general population.
· The ICU admission rate and ventilator requirement rate is only 0.35%. Only 4 people in the total sample set got very severe case of COVID.
· We categorized the comorbidities into cardiometabolic, immunodeficiency, neurological and organ systems related issues. People with heart-related diseases are more in the dataset. We were able to find that 10% of people with comorbidities ended up COVID positive and majority of the hospitalized patients had some co morbidities.
· We also calculated the health score of patients depending on how many co morbidities the patients have and in most of the cases, it was found to be OK.
· Close to 58% of MS patients in our dataset stopped DMTs in 2020 as DMTs were immunosuppressants. We were also able to spot that the number of relapsing-remitting patients was extremely high in 2020 compared to previous years which may be because of the stopping of drugs.
· There were a few categories of MS patients who were at more risk of developing a severe case of COVID than others. These were:
o People in the Progressive MS category. 50 % of them had to hospitalized.
o People who had some form of co morbidities.
o People with minor disabilities.
o People belonging to the age group of 50 above.
Again, in our dataset only very few people (15) developed severe COVID related issues. So, these insights regarding severe risk categories may only give a general idea and cannot be considered conclusive.
Conclusion
MS patients are not at a higher risk of contracting COVID compared to other patients, but the level of MS may affect the severity of the COVID cases. Also stopping DMTs may have resulted in more relapsing cases and interfered with the treatments. This is in tune with the research currently existing. Timely detection and correct treatment can help patients make a full COVID recovery and keep MS under check.
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