Natalizumab administration in multiple sclerosis patients during active SARS-CoV-2 infection: a case series

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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.

BMC Neurology
|November 29, 2021
PubMed
Abstract

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.
Keywords:
COVID-19Multiple sclerosisNatalizumabSARS-CoV-2 active infection

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