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

• Published in: Neurological sciences Vol. 41; no. 8; pp. 1981 - 1983
• Main Authors: Devogelaere, Jens, D’hooghe, Marie B., Vanderhauwaert, Famke, D’haeseleer, Miguel
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.08.2020; Springer Nature B.V
• Subjects: Adult; Betacoronavirus; CD20 antigen; Coronaviridae; Coronavirus Infections - immunology; Coronaviruses; COVID-19; Cytokine storm; Female; Humans; Immunocompromised Host; Immunologic Factors - therapeutic use; Immunosuppressive agents; Immunotherapy; Medicine; Medicine & Public Health; Monoclonal antibodies; Multiple sclerosis; Multiple Sclerosis, Relapsing-Remitting - drug therapy; Multiple Sclerosis, Relapsing-Remitting - virology; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Pandemics; Patients; Pneumonia, Viral - immunology; Psychiatry; Respiratory failure; Rituximab; Rituximab - therapeutic use; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Therapeutic applications; Vigilance; COVID-19; Multiple Sclerosis; Rituximab; Immunosuppression
• ISSN: 1590-1874; 1590-3478
• DOI: 10.1007/s10072-020-04522-2

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.