One thing that has bothered me in the 20 years since being diagnosed with multiple sclerosis is that people think of MS as an “immune-system condition,” so they assume that having MS means the immune system is weak. But the opposite is actually true in the case of MS, in which the immune system is overactive in a sense. Medications for MS tamp down the immune system in an effort to make it behave more like a normal person’s does.
In the meantime, reporters seem to enjoy pointing out how COVID-19 (Coronavirus Disease 2019) attacks people who have a “compromised” immune system. I’ve seen several physicians and viral experts explain that this particular coronavirus attacks people who have a strong immune system, causing a “cytokine storm” and inflammation in the lungs, making the lungs fill up with fluid – necessitating the patient to be on a ventilator to breathe.
People tend to assume that older people have a weak immune system and young people have a strong one, but the opposite is true here, too! Our immune system becomes stronger as we get older thanks to all of the invaders we’ve been exposed to over the years, which is why older people are more vulnerable to the COVID-19 coronavirus. There have been very few children and young people who have died from this virus, and that is because they don’t have a strong immune system, so the virus doesn’t create a cytokine storm in them.
Multiple Sclerosis and the Coronavirus
But then, does this mean that those of us with MS have a greater vulnerability to COVID-19, since it attacks those who have strong immune systems? The answer is yes – unless you’re on a disease-modifying medication, which likely brings your immune system back down to normal.
MS involves (1) the immune system and (2) the central nervous system. When the T-cells are activated in the immune system to attack an invader in someone with MS, the T-cells tend to accidentally attack the wrong thing. The T-cells specifically attack the protective fatty layer that covers our brain and spinal cord, called the myelin layer.
When the T-cells gobble up myelin, it leaves behind scars, or “sclerosis.” As I explain in my book “Game Over, MS,” the good news is that the bodies of most people with MS naturally replenish the spots of missing myelin with new myelin. However, the integrity of the new myelin isn’t usually as good as the original myelin. This lack of high-quality myelin supporting the nerves, or the nervous system, can cause the person to continue experiencing slight versions of the MS exacerbation that was caused by the missing myelin in the first place.
For example, if you had a bad cold or a stressful event and then experienced a temporary MS exacerbation of numbness in your feet, one or more tiny vestiges of the numbness might linger. You could have a small section of your foot that still feels numb indefinitely. (What happens is that you learn to ignore it after a while, because it doesn’t really hurt anything.)
But Back to COVID-19
Most times, the common cold is actually caused by a type of coronavirus, according to the Centers for Disease Control and Prevention (CDC). Indeed, we’re advised by our neurologists to avoid getting a cold because it can cause an MS exacerbation.
So does this mean that those of us with MS, and our somewhat-too-strong immune systems, are more susceptible to COVID-19 than others? Apparently not.
The National Multiple Sclerosis Society (NMSS) spells it out: “There is no increased risk of you getting COVID-19 because you have MS.” It says cautiously that those of us who are on immunosuppressing medication may be at a slightly increased risk, but what the medicine really does is to make our immune systems get back to normal – it doesn’t make our immunity worse.
A Red Herring
So essentially, having MS likely doesn’t make us more or less susceptible to developing a reaction to COVID-19 than anyone else. This virus is an enigma that researchers are still trying to figure out, so we just have to follow the directives like everyone else.
…And it’s all the more reason for those of us with MS to keep our weight at a healthy level and to avoid smoking and various air pollutants. Keep the body strong!