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10.1016/j.msard.2020.102180

http://scihub22266oqcxt.onion/10.1016/j.msard.2020.102180
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32408155!7202802!32408155
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suck abstract from ncbi


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pmid32408155      Mult+Scler+Relat+Disord 2020 ; 42 (ä): 102180
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  • Severe COVID-19 infection in a patient with multiple sclerosis treated with fingolimod #MMPMID32408155
  • Foerch C; Friedauer L; Bauer B; Wolf T; Adam EH
  • Mult Scler Relat Disord 2020[Jul]; 42 (ä): 102180 PMID32408155show ga
  • BACKGROUND: Fingolimod is used for immune therapy in patients with multiple sclerosis. Long-term treatment is associated with a small increase in the risk of herpes virus reactivation and respiratory tract infections. Patients with coronavirus disease 2019 (COVID-19) under Fingolimod treatment have not been described. METHODS AND RESULTS: We report a 57-year old female patient with a relapsing remitting multiple sclerosis under fingolimod treatment who experienced a severe COVID-19 infection in March 2020 (Extended Disability Status Scale: 2.0). Having peripheral lymphopenia typical for fingolimod treatment (total lymphocytes 0.39/nL [reference range 1.22-3.56]), the patient developed bilateral interstitial pneumonia with multiple ground-glass opacities on chest CT. Fingolimod medication was stopped. On the intensive care unit, non-invasive ventilation was used to provide oxygen and ventilation support regularly. Over the following two days, oxygenation improved, and the patient was transferred to a normal ward five days after admission. CONCLUSION: The implications fingolimod has on COVID-19 are complex. As an S1P analogue, fingolimod might enhance lung endothelial cell integrity. In addition, in case of a so-called cytokine storm, immunomodulation might be beneficial to reduce mortality. Future studies are needed to explore the risks and therapeutic effects of fingolimod in COVID-19 patients.
  • |Betacoronavirus[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/complications/diagnostic imaging/*physiopathology/therapy[MESH]
  • |Deprescriptions[MESH]
  • |Female[MESH]
  • |Fingolimod Hydrochloride/*therapeutic use[MESH]
  • |Humans[MESH]
  • |Immunosuppressive Agents/*therapeutic use[MESH]
  • |Middle Aged[MESH]
  • |Multiple Sclerosis, Relapsing-Remitting/complications/*drug therapy[MESH]
  • |Noninvasive Ventilation[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/complications/diagnostic imaging/*physiopathology/therapy[MESH]
  • |SARS-CoV-2[MESH]
  • |Severity of Illness Index[MESH]


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