Coronavirus disease 2019: favorable outcome in an immunosuppressed patient with multiple sclerosis

Neurol Sci. 2020 Aug;41(8):1981-1983. doi: 10.1007/s10072-020-04522-2. Epub 2020 Jun 20.

Abstract

The rapid and global spread of severe acute respiratory syndrome coronavirus 2, a viral pathogen responsible for the development of the "coronavirus disease of 2019" (COVID-19), has developed into an unprecedented health crisis with considerable case fatality rate. Patients with comorbidities are considered to be at higher risk for severe disease with acute respiratory failure, intensive care unit admission, and/or death. Particular vigilance has been warranted regarding the continuation of immunosuppressive treatments since viral clearing may be hampered in such cases. In contrast, it has also been hypothesized that overactive immune responses may trigger a cytokine storm associated with clinical deterioration, which has generated an interest in certain immunosuppressant drugs as potential treatment for COVID-19. We would like to present the first case report of a patient who was formally diagnosed with COVID-19 while being under disease-modifying treatment with rituximab, an anti-CD20 B cell depleting agent, for multiple sclerosis. The clinical picture was mild for which we have tried to provide an immunopathological framework.

Keywords: COVID-19; Immunosuppression; Multiple Sclerosis; Rituximab.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / immunology*
  • Female
  • Humans
  • Immunocompromised Host*
  • Immunologic Factors / therapeutic use
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy
  • Multiple Sclerosis, Relapsing-Remitting / virology*
  • Pandemics
  • Pneumonia, Viral / immunology*
  • Rituximab / therapeutic use
  • SARS-CoV-2

Substances

  • Immunologic Factors
  • Rituximab