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Potential COVID-19 infection in patients with severe multiple sclerosis treated with alemtuzumab.
Mult Scler Relat Disord. 2020 Jun 11; 44:102297.MS

Abstract

BACKGROUND

Management of disease-modifying therapies in Multiple Sclerosis (MS) during the COVID-19 pandemic is a controversial issue. Alemtuzumab is an immunosuppressive drug that induces lymphocytes depletion. In this study, we aimed to evaluate the frequency and severity of COVID-19 in a case series of patients treated with alemtuzumab in our center.

METHODS

Ten patients with a diagnosis of relapsing-remitting MS were phoned and asked about symptoms suggestive and COVID-19 using a semi-structured questionnaire.

RESULTS

The mean age was 43.7 ± 9.65 years old, and 8 (80%) were females. The mean time since disease diagnosis was 17.30 ± 8.59 years, and all were patients with relapsing-remitting MS. Mean time from the last dose of Alemtuzumab was 9.80 ± 6.64 months, and last lymphocyte count was 760 ± 231 / μL. Two patients (20%) developed symptoms highly suggestive of COVID-19. Disease duration was 2 and 7 days. None patient required hospital admission. Patients with COVID-19 symptoms had longer clinical course of MS. Conversely, we did not find statistically significant differences regarding age, EDSS, last lymphocyte count, and months since the last dose of alemtuzumab administered between patients having or not symptoms of COVID-19.

CONCLUSIONS

Our data suggest that patients receiving alemtuzumab showed very mild symptoms of COVID-19. We speculate that immune reconstitution induced by treatment may induce positive changes in the immune system in the defense against SARS-CoV2. Further research about alemtuzumab and their role in COVID-infection is necessary to confirm these preliminary findings.

Authors+Show Affiliations

Department of Neurology, Institute of Neurosciences. Hospital Clínico San Carlos. San Carlos Health Research Institute (IdISSC). Universidad Complutense de Madrid, Profesor Martín Lagos s/n., 28040 Madrid, Spain.Department of Neurology, Institute of Neurosciences. Hospital Clínico San Carlos. San Carlos Health Research Institute (IdISSC). Universidad Complutense de Madrid, Profesor Martín Lagos s/n., 28040 Madrid, Spain.Department of Neurology, Institute of Neurosciences. Hospital Clínico San Carlos. San Carlos Health Research Institute (IdISSC). Universidad Complutense de Madrid, Profesor Martín Lagos s/n., 28040 Madrid, Spain.Department of Neurology, Institute of Neurosciences. Hospital Clínico San Carlos. San Carlos Health Research Institute (IdISSC). Universidad Complutense de Madrid, Profesor Martín Lagos s/n., 28040 Madrid, Spain.Department of Neurology, Institute of Neurosciences. Hospital Clínico San Carlos. San Carlos Health Research Institute (IdISSC). Universidad Complutense de Madrid, Profesor Martín Lagos s/n., 28040 Madrid, Spain. Electronic address: jordi.matias-guiu@salud.madrid.org.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32554284

Citation

Matías-Guiu, Jorge, et al. "Potential COVID-19 Infection in Patients With Severe Multiple Sclerosis Treated With Alemtuzumab." Multiple Sclerosis and Related Disorders, vol. 44, 2020, p. 102297.
Matías-Guiu J, Montero-Escribano P, Pytel V, et al. Potential COVID-19 infection in patients with severe multiple sclerosis treated with alemtuzumab. Mult Scler Relat Disord. 2020;44:102297.
Matías-Guiu, J., Montero-Escribano, P., Pytel, V., Porta-Etessam, J., & Matias-Guiu, J. A. (2020). Potential COVID-19 infection in patients with severe multiple sclerosis treated with alemtuzumab. Multiple Sclerosis and Related Disorders, 44, 102297. https://doi.org/10.1016/j.msard.2020.102297
Matías-Guiu J, et al. Potential COVID-19 Infection in Patients With Severe Multiple Sclerosis Treated With Alemtuzumab. Mult Scler Relat Disord. 2020 Jun 11;44:102297. PubMed PMID: 32554284.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Potential COVID-19 infection in patients with severe multiple sclerosis treated with alemtuzumab. AU - Matías-Guiu,Jorge, AU - Montero-Escribano,Paloma, AU - Pytel,Vanesa, AU - Porta-Etessam,Jesús, AU - Matias-Guiu,Jordi A, Y1 - 2020/06/11/ PY - 2020/05/12/received PY - 2020/05/20/revised PY - 2020/06/09/accepted PY - 2020/6/20/pubmed PY - 2020/6/20/medline PY - 2020/6/20/entrez KW - Alemtuzumab KW - Covid-19 KW - Cytokine storm KW - Multiple sclerosis KW - SARS-Cov2 SP - 102297 EP - 102297 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 44 N2 - BACKGROUND: Management of disease-modifying therapies in Multiple Sclerosis (MS) during the COVID-19 pandemic is a controversial issue. Alemtuzumab is an immunosuppressive drug that induces lymphocytes depletion. In this study, we aimed to evaluate the frequency and severity of COVID-19 in a case series of patients treated with alemtuzumab in our center. METHODS: Ten patients with a diagnosis of relapsing-remitting MS were phoned and asked about symptoms suggestive and COVID-19 using a semi-structured questionnaire. RESULTS: The mean age was 43.7 ± 9.65 years old, and 8 (80%) were females. The mean time since disease diagnosis was 17.30 ± 8.59 years, and all were patients with relapsing-remitting MS. Mean time from the last dose of Alemtuzumab was 9.80 ± 6.64 months, and last lymphocyte count was 760 ± 231 / μL. Two patients (20%) developed symptoms highly suggestive of COVID-19. Disease duration was 2 and 7 days. None patient required hospital admission. Patients with COVID-19 symptoms had longer clinical course of MS. Conversely, we did not find statistically significant differences regarding age, EDSS, last lymphocyte count, and months since the last dose of alemtuzumab administered between patients having or not symptoms of COVID-19. CONCLUSIONS: Our data suggest that patients receiving alemtuzumab showed very mild symptoms of COVID-19. We speculate that immune reconstitution induced by treatment may induce positive changes in the immune system in the defense against SARS-CoV2. Further research about alemtuzumab and their role in COVID-infection is necessary to confirm these preliminary findings. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/32554284/Potential_COVID_19_infection_in_patients_with_severe_multiple_sclerosis_treated_with_alemtuzumab_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(20)30373-4 DB - PRIME DP - Unbound Medicine ER -
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