COVID-19 in a MS patient treated with ocrelizumab: does immunosuppression have a protective role?
Open accessAbstract
Background Coronavirus disease 19 (COVID-19) is a novel disease entity that is spreading throughout the world. It has been speculated that patients with comorbidities and elderly patients could be at high risk for respiratory insufficiency and death. Immunosuppression could expose infected patients to even higher risks of disease complications due to dampened immune response. However, it has been speculated that overactive immune response could drive clinical deterioration and, based on this hypothesis, several immunosuppressants are currently being tested as potential treatment for COVID-19.Methods In this paper we report on a patient that has been treated with ocrelizumab (a B-cell depleting monoclonal antibody) for primary progressive multiple sclerosis who developed COVID-19.Results Despite complete B cell depletion, patient symptoms abated few days after hospitalization, and he was discharged to home-quarantine. Phone interview follow-up confirmed that, after 14 days, no new symptoms occurred.Discussion This report supports the putative role of immunosuppressive therapy in COVID-19 affected patients.
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Three studies totaling 31 COVID-19 cases in subjects on B cell depletion therapy reported all cases resolved without intensive care.
“Three studies, with a total of 31 COVID-19 cases, of subjects on B cell depletion therapy reported all COVID-19 cases resolved without intensive care (Montero-Escribano et al., 2020; Novi et al., 2020; Safavi et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Novi et al., 2020
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Clinical characteristics of coronavirus disease 2019 in China
Guan, W.-J., Ni, Z.-Y., Hu, Y., Liang, W.-H., Ou, C.-Q., He, J.-X., Liu, L., Shan, H., Lei, C.-L., Hui, D. S. C., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2002032 · Cited by 30,246 · see citing works
COVID-19: consider cytokine storm syndromes and immunosuppression
Mehta, P., McAuley, D. F., Brown, M., Sanchez, E., Tattersall, R. S., & Manson, J. J. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30628-0 · Cited by 9,664 · see citing works
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Adaptive immunity to SARS-CoV-2 and COVID-19
Sette, A., & Crotty, S. (2021) · Cell · doi:10.1016/j.cell.2021.01.007 · Cited by 1,860 · see citing works
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Montero-Escribano, P., Matías-Guiu, J., Gómez-Iglesias, P., Porta-Etessam, J., Pytel, V., & Matias-Guiu, J. A. (2020) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2020.102185 · Cited by 128 · see citing works
Recovery from COVID-19 in a B-cell-depleted multiple sclerosis patient
Wurm, H., Attfield, K., Iversen, A. K., Gold, R., Fugger, L., & Haghikia, A. (2020) · Multiple Sclerosis Journal · doi:10.1177/1352458520943791 · Cited by 36 · see citing works
- Authors
- Novi, G., Mikulska, M., Briano, F., Toscanini, F., Tazza, F., Uccelli, A., & Inglese, M.
- Affiliations
- Ospedale Policlinico San Martino (IT)
- Corresponding author
- Inglese, Matilde
- Venue
- Multiple Sclerosis and Related Disorders
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 42
- Pages
- 102120
- ISSN
- 2211-0348 (ISSN-L)
- PMC
- PMC7156942
- OpenAlex
- W3016673289
- Cited by
- 162
- References
- 3
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 9 · 2022: 17 · 2021: 44 · 2020: 85
- FWCI
- 5.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Multiple Sclerosis and Related Disorders (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- Funders
- Novartis
- Roche
- National Institutes of Health
- Biogen
- Fondazione Italiana Sclerosi Multipla
- Genzyme
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Keywords
- COVID-19 pandemic, ocrelizumab, multiple sclerosis, primary progressive multiple sclerosis, immunosuppression, B-cell depletion, monoclonal antibody therapy, COVID-19 treatment, immune response
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Humans, Immunologic Factors, Male, Middle Aged, Pneumonia, Viral, Severity of Illness Index, Coronavirus Infections, Multiple Sclerosis, Chronic Progressive, Pandemics, Antibodies, Monoclonal, Humanized, Protective Factors
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