Benign SARS-CoV-2 infection in MOG-antibodies associated disorder during tocilizumab treatment

doi:10.1016/j.msard.2020.102592

Case Reports

. 2020 Nov:46:102592.

doi: 10.1016/j.msard.2020.102592. Epub 2020 Oct 21.

Benign SARS-CoV-2 infection in MOG-antibodies associated disorder during tocilizumab treatment

Fabio Giuseppe Masuccio¹, Marianna Lo Re², Antonio Bertolotto², Marco Capobianco², Claudio Solaro³

Affiliations

¹ Department of Rehabilitation, C.R.R.F. "Mons. L. Novarese", Loc. Trompone, Moncrivello, Italy.
² Department of Neurology and Regional Referral Multiple Sclerosis Centre, University-Hospital S. Luigi Gonzaga, Orbassano, Italy.
³ Department of Rehabilitation, C.R.R.F. "Mons. L. Novarese", Loc. Trompone, Moncrivello, Italy. Electronic address: csolaro@libero.it.

PMID: 33296987
PMCID: PMC7576324
DOI: 10.1016/j.msard.2020.102592

Case Reports

Benign SARS-CoV-2 infection in MOG-antibodies associated disorder during tocilizumab treatment

Fabio Giuseppe Masuccio et al. Mult Scler Relat Disord. 2020 Nov.

. 2020 Nov:46:102592.

doi: 10.1016/j.msard.2020.102592. Epub 2020 Oct 21.

Authors

Fabio Giuseppe Masuccio¹, Marianna Lo Re², Antonio Bertolotto², Marco Capobianco², Claudio Solaro³

Affiliations

¹ Department of Rehabilitation, C.R.R.F. "Mons. L. Novarese", Loc. Trompone, Moncrivello, Italy.
² Department of Neurology and Regional Referral Multiple Sclerosis Centre, University-Hospital S. Luigi Gonzaga, Orbassano, Italy.
³ Department of Rehabilitation, C.R.R.F. "Mons. L. Novarese", Loc. Trompone, Moncrivello, Italy. Electronic address: csolaro@libero.it.

PMID: 33296987
PMCID: PMC7576324
DOI: 10.1016/j.msard.2020.102592

Abstract

Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) represents a demyelinating disorder for which tocilizumab, an anti-IL6 receptor, has been tested to prevent disabling relapses. In a subgroup of patients affected with novel Coronavirus disease (COVID-19), tocilizumab has also increased the survival rate. We present the case of a 31-years-old Caucasian patient who experienced an almost asymptomatic Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection during treatment with tocilizumab, which was continued due to the very high risk of relapses of the patient. According to this case, tocilizumab might be not discontinued during COVID-19.

Keywords: Anti-IL6 receptor; COVID-19; MOGAD; Monoclonal antibody; SARS-CoV-2; Tocilizumab.

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Conflict of interest statement

Fabio Giuseppe Masuccio and Marianna Lo Re declare no conflict of interest. Antonio Bertolotto served on the advisory boards of Alexion, Biogen, Novartis, Sanofi and/or received speaking honoraria from Alexion, Biogen, Novartis, Sanofi and grant support from Almiral, Biogen, Associazione San Luigi Gonzaga ONLUS, Fondazione per la Ricerca Biomedica ONLUS, Novartis and the Italian Multiple Sclerosis Society. Marco Capobianco received personal fees and compensation for speaking at medical meeting and participating in advisory board from Almirall, Biogen, Merck, Sanofi, Roche, Novartis. Claudio Solaro served on the advisory boards of Biogen Idec and Merck Serono. He received speaking honoraria from Bayer Schering, Biogen Idec, Merck Serono, Almirall, Teva and Genzyme. He received research grants and support from the Italian MS Society Research Foundation (Fondazione Italiana Sclerosi Multipla).

Figures

**Fig. 1**
Timeline of tocilizumab treatment during Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection.

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References

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1. Whittam D.H., Karthikeayan V., Gibbons E., Kneen R., Chandratre S., Ciccarelli O., Hacohen Y., de Seze J., Deiva K., Hintzen R.Q., Wildemann B., Jarius S., Kleiter I., Rostasy K., Huppke P., Hemmer B., Paul F., Aktas O., Pröbstel A.K., Arrambide G., Tintore M., Amato M.P., Nosadini M., Mancardi M.M., Capobianco M., Illes Z., Siva A., Altintas A., Akman-Demir G., Pandit L., Apiwattankul M., Hor J.Y., Viswanathan S., Qiu W., Kim H.J., Nakashima I., Fujihara K., Ramanathan S., Dale R.C., Boggild M., Broadley S., Lana-Peixoto M.A., Sato D.K., Tenembaum S., Cabre P., Wingerchuk D.M., Weinshenker B.G., Greenberg B., Matiello M., Klawiter E.C., Bennett J.L., Wallach A.I., Kister I., Banwell B.L., Traboulsee A., Pohl D., Palace J., Leite M.I., Levy M., Marignier R., Solomon T., Lim M., Huda S., Jacob A. Treatment of MOG antibody associated disorders: results of an international survey. J. Neurol. 2020 doi: 10.1007/s00415-020-10026-y. - DOI - PMC - PubMed
1. Wynford-Thomas R., Jacob A., Tomassini V. Neurological update: MOG antibody disease. J. Neurol. 2019;266:1280–1286. doi: 10.1007/s00415-018-9122-2. - DOI - PMC - PubMed

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[1] Capra R., Rossi N.D., Mattioli F., Romanelli G., Scarpazza C., Pia M., Cossi S. Impact of low dose tocilizumab on mortality rate in patients with COVID-19 related pneumonia. Eur. J. Int. Med. 2020 - PMC - PubMed

[2] Capra R., Rossi N.D., Mattioli F., Romanelli G., Scarpazza C., Pia M., Cossi S. Impact of low dose tocilizumab on mortality rate in patients with COVID-19 related pneumonia. Eur. J. Int. Med. 2020 - PMC - PubMed

[3] Jarius S., Ruprecht K., Kleiter I., Borisow N., Asgari N., Pitarokoili K., Pache F., Stich O., Beume L.A., Hümmert M.W., Ringelstein M., Trebst C., Winkelmann A., Schwarz A., Buttmann M., Zimmermann H., Kuchling J., Franciotta D., Capobianco M., Siebert E., Lukas C., Korporal-Kuhnke M., Haas J., Fechner K., Brandt A.U., Schanda K., Aktas O., Paul F., Reindl M., Wildemann B. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome. J. Neuroinflamm. 2016;13:1–45. doi: 10.1186/s12974-016-0718-0. - DOI - PMC - PubMed

[4] Jarius S., Ruprecht K., Kleiter I., Borisow N., Asgari N., Pitarokoili K., Pache F., Stich O., Beume L.A., Hümmert M.W., Ringelstein M., Trebst C., Winkelmann A., Schwarz A., Buttmann M., Zimmermann H., Kuchling J., Franciotta D., Capobianco M., Siebert E., Lukas C., Korporal-Kuhnke M., Haas J., Fechner K., Brandt A.U., Schanda K., Aktas O., Paul F., Reindl M., Wildemann B. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome. J. Neuroinflamm. 2016;13:1–45. doi: 10.1186/s12974-016-0718-0. - DOI - PMC - PubMed

[5] Toniati P., Piva S., Cattalini M., Garrafa E., Regola F., Castelli F., Franceschini F., Airò P., Bazzani C., Beindorf E.A., Berlendis M., Bezzi M., Bossini N., Castellano M., Cattaneo S., Cavazzana I., Contessi G.B., Crippa M., Delbarba A., De Peri E., Faletti A., Filippini M., Frassi M., Gaggiotti M., Gorla R., Lanspa M., Lorenzotti S., Marino R., Maroldi R., Metra M., Matteelli A., Modina D., Moioli G., Montani G., Muiesan M.L., Odolini S., Peli E., Pesenti S., Pezzoli M.C., Pirola I., Pozzi A., Proto A., Rasulo F.A., Renisi G., Ricci C., Rizzoni D., Romanelli G., Rossi M., Salvetti M., Scolari F., Signorini L., Taglietti M., Tomasoni G., Tomasoni L.R., Turla F., Valsecchi A., Zani D., Zuccalà F., Zunica F., Focà E., Andreoli L., Latronico N. Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: a single center study of 100 patients in Brescia, Italy. Autoimmun. Rev. 2020;19 doi: 10.1016/j.autrev.2020.102568. - DOI - PMC - PubMed

[6] Toniati P., Piva S., Cattalini M., Garrafa E., Regola F., Castelli F., Franceschini F., Airò P., Bazzani C., Beindorf E.A., Berlendis M., Bezzi M., Bossini N., Castellano M., Cattaneo S., Cavazzana I., Contessi G.B., Crippa M., Delbarba A., De Peri E., Faletti A., Filippini M., Frassi M., Gaggiotti M., Gorla R., Lanspa M., Lorenzotti S., Marino R., Maroldi R., Metra M., Matteelli A., Modina D., Moioli G., Montani G., Muiesan M.L., Odolini S., Peli E., Pesenti S., Pezzoli M.C., Pirola I., Pozzi A., Proto A., Rasulo F.A., Renisi G., Ricci C., Rizzoni D., Romanelli G., Rossi M., Salvetti M., Scolari F., Signorini L., Taglietti M., Tomasoni G., Tomasoni L.R., Turla F., Valsecchi A., Zani D., Zuccalà F., Zunica F., Focà E., Andreoli L., Latronico N. Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: a single center study of 100 patients in Brescia, Italy. Autoimmun. Rev. 2020;19 doi: 10.1016/j.autrev.2020.102568. - DOI - PMC - PubMed

[7] Whittam D.H., Karthikeayan V., Gibbons E., Kneen R., Chandratre S., Ciccarelli O., Hacohen Y., de Seze J., Deiva K., Hintzen R.Q., Wildemann B., Jarius S., Kleiter I., Rostasy K., Huppke P., Hemmer B., Paul F., Aktas O., Pröbstel A.K., Arrambide G., Tintore M., Amato M.P., Nosadini M., Mancardi M.M., Capobianco M., Illes Z., Siva A., Altintas A., Akman-Demir G., Pandit L., Apiwattankul M., Hor J.Y., Viswanathan S., Qiu W., Kim H.J., Nakashima I., Fujihara K., Ramanathan S., Dale R.C., Boggild M., Broadley S., Lana-Peixoto M.A., Sato D.K., Tenembaum S., Cabre P., Wingerchuk D.M., Weinshenker B.G., Greenberg B., Matiello M., Klawiter E.C., Bennett J.L., Wallach A.I., Kister I., Banwell B.L., Traboulsee A., Pohl D., Palace J., Leite M.I., Levy M., Marignier R., Solomon T., Lim M., Huda S., Jacob A. Treatment of MOG antibody associated disorders: results of an international survey. J. Neurol. 2020 doi: 10.1007/s00415-020-10026-y. - DOI - PMC - PubMed

[8] Whittam D.H., Karthikeayan V., Gibbons E., Kneen R., Chandratre S., Ciccarelli O., Hacohen Y., de Seze J., Deiva K., Hintzen R.Q., Wildemann B., Jarius S., Kleiter I., Rostasy K., Huppke P., Hemmer B., Paul F., Aktas O., Pröbstel A.K., Arrambide G., Tintore M., Amato M.P., Nosadini M., Mancardi M.M., Capobianco M., Illes Z., Siva A., Altintas A., Akman-Demir G., Pandit L., Apiwattankul M., Hor J.Y., Viswanathan S., Qiu W., Kim H.J., Nakashima I., Fujihara K., Ramanathan S., Dale R.C., Boggild M., Broadley S., Lana-Peixoto M.A., Sato D.K., Tenembaum S., Cabre P., Wingerchuk D.M., Weinshenker B.G., Greenberg B., Matiello M., Klawiter E.C., Bennett J.L., Wallach A.I., Kister I., Banwell B.L., Traboulsee A., Pohl D., Palace J., Leite M.I., Levy M., Marignier R., Solomon T., Lim M., Huda S., Jacob A. Treatment of MOG antibody associated disorders: results of an international survey. J. Neurol. 2020 doi: 10.1007/s00415-020-10026-y. - DOI - PMC - PubMed

[9] Wynford-Thomas R., Jacob A., Tomassini V. Neurological update: MOG antibody disease. J. Neurol. 2019;266:1280–1286. doi: 10.1007/s00415-018-9122-2. - DOI - PMC - PubMed

[10] Wynford-Thomas R., Jacob A., Tomassini V. Neurological update: MOG antibody disease. J. Neurol. 2019;266:1280–1286. doi: 10.1007/s00415-018-9122-2. - DOI - PMC - PubMed

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Benign SARS-CoV-2 infection in MOG-antibodies associated disorder during tocilizumab treatment

Affiliations

Benign SARS-CoV-2 infection in MOG-antibodies associated disorder during tocilizumab treatment

Authors

Affiliations

Abstract

Conflict of interest statement

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