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Natalizumab administration in multiple sclerosis patients during active SARS-CoV-2 infection: a case series
Clara G Chisari1, Simona Toscano1, Sebastiano Arena1
1Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", section of Neurosciences, University of Catania, via Santa Sofia 78, 95123, Catania, Italy.
Background:
The Coronavirus disease 2019 (COVID-19) caused by the new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has become a pandemic, affecting the therapeutic management for Multiple Sclerosis (MS). Any decision regarding the discontinuation of high-potency agents for moderate and highly active MS should be carefully evaluated, taking into account the potential risk of rebound of the disease. In particular, no data about clinical outcome of patients with MS receiving Natalizumab (NTZ) during active COVID-19 infection have been reported yet.
Cases Presentation:
We reported on 6 patients treated with NTZ for relapsing MS during active COVID-19 infection, who recovered without reporting any worsening or new symptoms. Most of the patients were asymptomatic, with the exception of one patient who had a slight worst COVID-19 clinical course. No patients received O2-therapy or required intensive care. No neurological complications were observed.
Conclusions:
This paper reported the clinical outcome of patients with MS receiving NTZ during active COVID-19 infection. This case series suggests that treatment with NTZ during pandemic is relatively safe and might be continued in selected patients who are infected by COVID-19, thereby reducing the risk of MS disease rebound.
Insights
Patients with Multiple Sclerosis (MS) on Natalizumab (NTZ) generally tolerated COVID-19 well. Continuing NTZ during COVID-19 infection may be safe and prevent MS relapses.
Area of Science:
- Neurology
- Immunology
- Infectious Diseases
Background:
- The COVID-19 pandemic has impacted management strategies for Multiple Sclerosis (MS).
- Discontinuation of high-potency MS therapies requires careful risk-benefit assessment, especially concerning disease rebound.
- Limited data existed on the outcomes of MS patients on Natalizumab (NTZ) during active COVID-19 infection.
Purpose of the Study:
- To report the clinical outcomes of patients with MS receiving Natalizumab (NTZ) during active COVID-19 infection.
- To assess the safety and feasibility of continuing NTZ therapy during the COVID-19 pandemic in MS patients.
Main Methods:
- A case series of 6 patients with relapsing MS treated with Natalizumab (NTZ) during active COVID-19 infection was analyzed.
- Clinical outcomes, including disease worsening, need for oxygen therapy, intensive care admission, and neurological complications, were monitored.
Main Results:
- All 6 patients recovered from COVID-19 without worsening of MS symptoms or new neurological events.
- Most patients were asymptomatic; one experienced a mild COVID-19 clinical course.
- No patients required oxygen therapy or intensive care; no neurological complications were observed.
Conclusions:
- Continuing Natalizumab (NTZ) treatment in selected Multiple Sclerosis (MS) patients during COVID-19 infection appears relatively safe.
- Maintaining NTZ therapy may help mitigate the risk of MS disease rebound during the pandemic.
- This case series provides initial evidence supporting the continuation of NTZ in MS patients infected with COVID-19.
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