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A fine balance: Immunosuppression and immunotherapy in a patient with multiple sclerosis and COVID-19

Cristina Valencia-Sanchez1, Dean M Wingerchuk1

  • 1Neurology Department, Mayo Clinic Arizona, 13400 East Shea Boulevard, 85259 Scottsdale, Arizona, United States.

Multiple Sclerosis and Related Disorders
|May 17, 2020
PubMed
Abstract

Insights

Fingolimod-treated multiple sclerosis (MS) patients with severe COVID-19 may recover with tocilizumab. This treatment may be effective without worsening MS.

Area of Science:

  • Neurology
  • Immunology
  • Infectious Diseases

Background:

  • Multiple sclerosis (MS) treatment decisions are complex during the COVID-19 pandemic.
  • The impact of disease-modifying therapies, particularly immunosuppressants, on COVID-19 risk and outcomes remains unclear.

Observation:

  • A case report details a multiple sclerosis patient treated with fingolimod.
  • This patient developed severe COVID-19.

Findings:

  • The patient recovered from severe COVID-19 after receiving tocilizumab treatment.
  • Tocilizumab treatment for COVID-19 did not appear to exacerbate the patient's underlying multiple sclerosis.

Implications:

  • Tocilizumab may be a potential therapeutic option for severe COVID-19 in multiple sclerosis patients on immunosuppressants.
  • Further research is warranted to confirm the safety and efficacy of tocilizumab in this patient population.
Keywords:
COVID-19FingolimodMultiple sclerosisTocilizumab

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