Rituximab and risk of COVID-19 infection and its severity in patients with MS and NMOSD

• Published in: BMC neurology Vol. 21; no. 1; pp. 183 - 8
• Main Authors: Esmaeili, Sara, Abbasi, Mohammad Hossein, Abolmaali, Meysam, Mojtahed, Mohammad, Alavi, Seyedeh Niloufar Rafiei, Soleimani, Sevim, Mokhtari, Mahisa, Hatam, Jaber, Khotbehsara, Samaneh Tanhapour, Motamed, Mohammad Reza, Joghataei, Mohammad Taghi, Mirzaasgari, Zahra, Moghaddasi, Mehdi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01.05.2021; BioMed Central; BMC
• Subjects: Adolescent; Adult; Age; Coronaviruses; Corticosteroids; COVID-19; COVID-19 - epidemiology; Disease; Disease modifying therapy; Drug therapy; Fatalities; Female; Hospitalization; Hospitals; Humans; Illnesses; Immunologic Factors - administration & dosage; Immunologic Factors - adverse effects; Immunotherapy; Infections; Male; Medical research; Monoclonal antibodies; Multiple sclerosis; Multiple Sclerosis - epidemiology; Neuromyelitis Optica; NMO; Pandemics; Patients; Questionnaires; Recurrence; Rituximab; Rituximab - administration & dosage; Rituximab - adverse effects; Severe acute respiratory syndrome coronavirus 2; Statistics; Young Adult; Iran; COVID-19; NMO; Neuromyelitis Optica; Multiple sclerosis; MS; Rituximab; Disease modifying therapy
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/s12883-021-02218-4

Choosing a safe disease modifying therapy during the COVID-19 pandemic is challenging. This case series study was conducted to determine the incidence rate and the course of Covid-19 infection in MS/NMOSD patients treated with Rituximab. In this study, we designed a web-based questionnaire. Baseline information such as patient- reported walking disability, total number of Rituximab infusions received, delayed injections, occurrence of any relapse, and the use of corticosteroids during the pandemic were collected. Also, information regarding the Covid-19 pandemic such as adherence to self-isolation, any recent exposure to an infected individual and the presence of suggestive symptoms were collected. In case of positive test results, patients were grouped into 2 categories; mild to moderate and seriously ill and outcomes were evaluated as favorable (improved/ discharged) and unfavorable (expired). Two hundred fifty-eight patients with Multiple Sclerosis were enrolled in this study, 9 of the subjects (3.4%) were confirmed positive for Covid-19, five of which required hospitalizations (55.5%), two patients required ICU admission (22.2%) and 2 two patients died (22.2%). None of these patients ever mentioned using corticosteroids during the pandemic. In comparison to MS patients who were not receiving disease modifying therapy (DMT), our study indicated a higher incidence of Covid-19 infection, higher ratio of serious illness and a higher fatality ratio. Rituximab seems not to be safe enough during the pandemic.