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Case Reports
. 2021 Jan;93(1):546-549.
doi: 10.1002/jmv.26279. Epub 2020 Jul 15.

Clinical exacerbation of SARS-CoV2 infection after fingolimod withdrawal

Victor Gomez-Mayordomo  1 , Paloma Montero-Escribano  1 , Jordi A Matías-Guiu  1 , Nuria González-García  1 , Jesús Porta-Etessam  1 , Jorge Matías-Guiu  1
Affiliations
Case Reports

Clinical exacerbation of SARS-CoV2 infection after fingolimod withdrawal

Victor Gomez-Mayordomo et al. J Med Virol. 2021 Jan.

Abstract

The role of disease-modifying therapies in patients with autoimmune disorders during severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection is controversial. Immunocompromised patients could have a more severe coronavirus disease-2019 (COVID-19) due to the absence of an adequate immune response against the SARS-CoV-2. However, therapies that act on immune response could play a protective role by dampening the cytokine-release syndrome. Fingolimod is a drug used for immune therapy in patients with multiple sclerosis (MS) through the sequestration of activated lymphocytes in the lymph nodes. We report the case of a 57-year-old man with relapsing-remitting MS treated with fingolimod that showed a reactivation of COVID-19 with signs of hyperinflammation syndrome after fingolimod withdrawal. Our case suggests that discontinuation of fingolimod during COVID-19 could imply a worsening of SARS-CoV2 infection.

Keywords: COVID-19; SARS-CoV-2; coronavirus; exacerbation; fingolimod; multiple sclerosis.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Radiological evolution of coronavirus disease‐2019 (COVID‐19) disease in the patient. Chest X‐ray on days 4 (A), 7 (B), and 14 (C) from the onset of COVID‐19 symptoms, showing no abnormalities. After the suspension of fingolimod (day 25), a radiological worsening is noted on the radiographs of day 30 (D) and day 42 (E)
See this image and copyright information in PMC

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