Fatal COVID-19 in an MS patient on natalizumab: A case report

We report a fatal case of COVID-19 in a 51-year-old African American woman with multiple sclerosis on natalizumab. She had multiple risk factors for severe COVID-19 disease including race, obesity, hypertension, and elevated inflammatory markers, but the contribution of natalizumab to her poor outco...

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Bibliographic Details
Published in:Multiple sclerosis journal - experimental, translational and clinical translational and clinical, 2020-07, Vol.6 (3)
Main Authors: Rimmer, Kathryn, Farber, Rebecca, Thakur, Kiran, Braverman, Genna, Podolsky, Dina, Sutherland, Lauren, Migliore, Christopher, Ryu, Yun Kyoung, Levin, Seth, De Jager, Philip L, Vargas, Wendy, Levine, Libby, Riley, Claire S
Format: Article
Language:English
Subjects:
Case Report
Case reports
Coronaviruses
COVID-19
Immunotherapy
Monoclonal antibodies
Multiple sclerosis
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Summary:We report a fatal case of COVID-19 in a 51-year-old African American woman with multiple sclerosis on natalizumab. She had multiple risk factors for severe COVID-19 disease including race, obesity, hypertension, and elevated inflammatory markers, but the contribution of natalizumab to her poor outcome remains unknown. We consider whether altered dynamics of peripheral immune cells in the context of natalizumab treatment could worsen the cytokine storm syndrome associated with severe COVID-19. We discuss extended interval dosing as a risk-reduction strategy for multiple sclerosis patients on natalizumab, and the use of interleukin-6 inhibitors in such patients who contract COVID-19.
ISSN:2055-2173
2055-2173
DOI:10.1177/2055217320942931