Background: Managing multiple sclerosis (MS) during the novel coronavirus (COVID-19) pandemic is a challenge due to the lack of evidence from clinical studies. Disease-modifying therapies (DMTs) may affect the immune response and subsequently alter the risk of COVID-19 infections.
Methods: A literature search was conducted on MEDLINE, Embase, and Cochrane databases. A focused Google search was also performed. The recommendations regarding the use of DMTs during the COVID-19 outbreak from national or international MS/neurology societies were identified and reviewed.
Results: The review included 16 recommendations from international and national MS organizations. All recommendations are based on expert opinions. The recommendations regarding DMT initiation and management during this outbreak were summarized. Moreover, the experts' views about the risk of COVID-19 infection with each DMT were discussed as well.
Conclusions: There is significant agreement among most experts' recommendations from a variety of sources based on collective clinical experience. However, the recommendations will likely evolve as sufficient clinical data are limited. Several ongoing registries will help to provide the information for future recommendations.