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Case Reports
. 2020 Oct:45:102402.
doi: 10.1016/j.msard.2020.102402. Epub 2020 Jul 17.

COVID-19 and multiple sclerosis: A description of two cases on alemtuzumab

Eva Fernández-Díaz  1 , Julia Gracia-Gil  2 , Jose Gregorio García-García  3 , María Palao  2 , Carlos M Romero-Sánchez  2 , Tomás Segura  4
Affiliations
Case Reports

COVID-19 and multiple sclerosis: A description of two cases on alemtuzumab

Eva Fernández-Díaz et al. Mult Scler Relat Disord. 2020 Oct.

Abstract

Background: Alemtuzumab is a treatment for highly active multiple sclerosis (MS). Immunosuppression is considered a risk factor for SARS-CoV-2 infection and there is still lack of evidence to guide MS practice.

Methods/results: We describe the clinical and immunological evolution of two MS patients under alemtuzumab treatment who were affected by COVID-19, one of them only one week after receiving her last dose, and both recovered without sequelae.

Conclusion: In selected patients (young, without comorbidities, and with high activity), MS itself could be more dangerous than COVID-19, so we should consider continuing MS treatment as previously planned, including alemtuzumab.

Keywords: Alemtuzumab; COVID-19; Immunosuppression; Multiple sclerosis; SARS-CoV-2.

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Conflict of interest statement

Declaration of Competing Interest The authors declared the following potential conflicts of interest: EFD and JGG have received research support, compensation for participating on advisory boards, lecture fees and/or travel support from: Almirall, Bayer, Genzyme-Sanofi, Novartis, Roche and Teva declare no potential conflicts of interest. JGGG has received research support, compensation for participating on advisory boards, lecture fees and/or travel support from: AbbVie, Bayer, Novartis, Angellini and Allergan. MP and CMRS have received support to attend congresses and conferences from Merck. TS has received compensation for participating in scientific advisory boards of Amgen Inc and Boehringer Ingelheim, and funding for travel or speaker honoraria of Bayer Pharmaceuticals and Daiichi-Sankyo. None of these companies are involved in the choice of content, writing or decision to publish this manuscript.

Figures

Fig. 1
Fig. 1
Temporal evolution of immune cells populations in our two MS patients who developed COVID-19 under alemtuzumab treatment across disease stages. A) Case 1: prior to infection, during COVID-19 and the next 2 months. B) Case 2: prior to alemtuzumab infusion, prior to infection, during COVID-19, and the next 2 months. Total count of lymphocytes (normal values: 1000–4000 cells/µL), neutrophils (normal values:1800–7500 cells/µL) and monocytes (normal values: 130–900 cells/µL) are represented in lines. Lymphocyte profile (CD4, CD8, CD19 and NK cells) are showed in bars, when available. Y2=year 2, 1M=1 month, 2M=2 months.
See this image and copyright information in PMC

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