Convalescent plasma in patients receiving Rituximab or Ocrelizumab for Multiple Sclerosis or Neuromyelitis Optica Spectrum Disorder with COVID-19: A Multicenter Retrospective Study

Despite vaccination, patients receiving anti-CD20 monoclonal antibodies (mAbs) for multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMOSD) have an increased risk of developing severe or protracted COVID-19. The aim of this study was to describe the effect of COVID-19 convalescent...

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Published in:International journal of infectious diseases 2024-12, p.107323
Main Authors: Dequidt, Tanguy, Richier, Quentin, Louapre, Céline, Ader, Florence, Merad, Yanis, Lauwerier, Nicolas, Jacomet, Christine, Carles, Michel, Biron, Charlotte, Gendrin, Vincent, Marlat, Clément, Danion, François, Lepage, Tristan M, Sotto, Albert, Bourdellon, Loïc, Mania, Alexandre, Martinot, Martin, Falher, Georges Le, Ferre, Alexis, Pilmis, Benoit, Gondran, Guillaume, Simeone, Pierre, Henry, Matthieu, Kamel, Toufik, Ray, Simon, Ancellin, Sophie, Mélé, Nicolas, Camou, Fabrice, Destremau, Marjolaine, Sellenet, Jeremy, Zucman, Noémie, Marechal, Marion Le, Mellouki, Khawla, Langlois, Marie-Elodie, Paz, David Luque, Mousset, Maud, Leclerc, Catherine, Sommet, Agnès, Lacombe, Karine, Martin-Blondel, Guillaume
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Language:English
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Summary:Despite vaccination, patients receiving anti-CD20 monoclonal antibodies (mAbs) for multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMOSD) have an increased risk of developing severe or protracted COVID-19. The aim of this study was to describe the effect of COVID-19 convalescent plasma (CCP) in patients with MS or NMOSD exposed to anti-CD20 and infected by SARS-CoV-2. This French national, retrospective cohort study was conducted between November 2020 and June 2023. Patients with MS or NMOSD, under anti-CD20 mAbs, with symptomatic COVID-19 and treated by CCP were screened. Protracted COVID-19 was defined by a duration of symptoms > 21 days. The primary endpoint was the overall survival 30 days after CCP administration. Ninety-two patients from 34 hospitals were included, 84 (91%) with MS and 8 (9%) with NMOSD. Overall, 30-day survival was 97% (IC95%: 91-99). SARS-CoV-2 viremia was positive in 47/75 (61%) patients before CCP versus 9/59 (15%) seven days post-CCP. In the 52 patients (57%) with protracted COVID-19, the duration of symptoms before CCP was 51 [28-69] days, including fever in 75% of cases, which disappeared in 100% of patients seven days post-CCP. CCP could be a therapeutic option in patients exposed to anti-CD20 mAbs for inflammatory demyelinating disease, particularly in those with protracted COVID-19.
ISSN:1878-3511