If you have ALS, you may have an increased risk of developing severe illness from COVID-19. Experts recommend staying up to date with your vaccinations to avoid contracting the SARS‐CoV‐2 virus.

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a condition that causes nervous system degeneration.

If you have ALS, you might be wondering how COVID-19 can affect your health. While there are currently only a handful of studies on the subject, people with ALS are most likely at an increased risk of severe illness from COVID-19.

This article provides an overview of findings from current studies, including important precautions to take if you or someone you care for has ALS.

ALS likely increases your risk of contracting SARS‐CoV‐2, the virus that causes COVID-19, but more research is needed to understand the specifics.

Immune system dysfunction might play a role. The authors of a 2020 review point out that ALS has links to signs of immune system overactivation. This could mean that ALS increases a person’s chances of contracting viruses or experiencing severe symptoms from them.

ALS also causes muscle weakness that makes it hard to breathe and cough to clear mucus. The authors of a 2023 review explain that this puts people with ALS at an increased risk of respiratory infection.

Another factor to keep in mind is that people with ALS who receive regular healthcare or live in long-term care facilities might be more likely to come into contact with the virus.

Although scientific data is lacking, preliminary research suggests that COVID-19 might cause serious complications in people with ALS.

The authors of a 2021 letter analyzed COVID-19 cases among veterans from January 2020 to February 2021. They reported that veterans with ALS were three times more likely than the rest of the veteran population to die of COVID-19 within 30 days of diagnosis.

Another 2021 letter focused on six people who tested positive for COVID-19 while hospitalized for ALS. The authors observed that people with ALS may have an increased risk of developing COVID-19 and experiencing complications.

Other researchers have theorized that COVID-19 could speed up the progression of ALS. In particular, the authors of a 2021 case report described two people who experienced an increase in ALS symptoms after contracting SARS‐CoV‐2 and recovering from COVID-19.

The authors of a 2022 study came to a similar conclusion after infecting mammalian cells with SARS‐CoV‐2 in a laboratory. They reported that infection with the virus appears to cause processes linked to neurodegeneration.

Still, all these studies have significant limitations, so it’s not possible to apply their results to everyone with ALS. More research is needed.

Can COVID-19 cause ALS?

Emerging research has linked SARS‐CoV‐2 infection to an increased risk of neurodegenerative disorders, particularly Alzheimer’s disease.

But it’s not clear whether COVID-19 might also be a risk factor for ALS. While there are individual case reports of ALS occurring after a SARS‐CoV‐2 infection, early studies suggest that the two conditions aren’t connected.

The authors of a 2022 study did not find a causal link between COVID-19 and ALS. Furthermore, the authors of a similar 2022 study suggested that SARS‐CoV‐2 infection might actually reduce the risk of ALS.

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As of 2023, the Centers for Disease Control and Prevention recommends that people ages 5 and older receive an updated dose of the COVID-19 vaccine. This includes people with ALS.

While COVID-19 vaccines may cause mild side effects, they offer protection against severe illness from SARS-CoV-2. This is particularly important for people with ALS, who are more likely to experience life threatening respiratory complications such as pneumonia.

There is no evidence that COVID-19 vaccines can worsen ALS.

If you have ALS or spend time with someone who does, you can take extra precautions to avoid COVID-19, including:

  • asking in-home attendants and visitors to take precautions
  • avoiding crowded places and indoor gatherings
  • avoiding close contact with people who might be sick
  • cleaning health equipment regularly
  • washing your hands frequently with soap and water
  • prioritizing sleep and a healthy diet
  • taking steps to improve ventilation at home
  • wearing a well-fitted mask or respirator

You should talk with your healthcare team if you’re experiencing any new symptoms, regardless of whether they are due to COVID-19.

Your primary care doctor is the first point of contact. If necessary, they will refer you to a specialist such as a neurologist, pulmonologist, or respiratory therapist.

More research is needed to understand how COVID-19 affects people with ALS, but ALS likely increases the risk of COVID-19 and related complications.

A few studies also suggest a potential link between COVID-19 and worsening ALS symptoms.

If you have ALS, getting vaccinated and taking other precautions can help you avoid getting sick, even if you’ve already had COVID-19. Talk with a healthcare professional to find out what you can do to avoid contracting the SARS-CoV-2 virus.