Table 1.

Suggested DMT management for COVID-19 prevention.

	Before (re)treatment	Follow-up after (re)treatment
Alemtuzumab	- SARS-CoV-2 serological testing and/or oro-pharyngeal swab - 14-day self-isolation	- Protective surgical-grade masks - Self-isolation or reduction in social contacts (also accounting for lymphocyte count)
Anti-CD20 (ocrelizumab, rituximab)	- SARS-CoV-2 serological testing and/or oro-pharyngeal swab - 14-day self-isolation	- Protective surgical-grade masks - Self-isolation or reduction in social contacts (also accounting for lymphocyte count) - Extended interval dosing, following CD19 lymphocyte count and in accordance with regulatory indications (if needed for social distancing in the infusion room)
Autologous haematopoietic stem cell transplantation	- SARS-CoV-2 serological testing and/or oro-pharyngeal swab - 14-day self-isolation	- Protective surgical-grade masks - Self-isolation or reduction in social contacts (also accounting for lymphocyte count)
Cladribine	- SARS-CoV-2 serological testing and/or oro-pharyngeal swab - 14-day self-isolation	- Protective surgical-grade masks - Self-isolation or reduction in social contacts (also accounting for lymphocyte count)
Dimethyl fumarate	- As usual	- More frequent FBC if lymphocytes <800/μL - Stop if lymphocytes <500/μL
Glatiramer acetate	- As usual	As usual
Interferon-beta	- As usual	- As usual
Natalizumab	- As usual	- Extended interval dosing, in accordance with regulatory indications (if needed for social distancing in the infusion room)
S1P inhibitors (fingolimod, siponimod)	- SARS-CoV-2 serological testing and/or oro-pharyngeal swab	- More frequent FBC if lymphocytes <500/μL - Alternate doses if lymphocytes <500/μL continuously - Stop if lymphocytes <200/μL
Teriflunomide	- As usual	- More frequent FBC if lymphocytes <800/μL - Stop if lymphocytes <500/μL

Table shows suggested procedures before treatment (or re-treatment), and during follow-up for different DMTs.