Fatal COVID-19 in an MS patient on natalizumab: A case report. Issue 3 (July 2020)

• Record Type: Journal Article
• 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
• Is Part Of: Multiple sclerosis journal, experimental, translational and clinical. Volume 6:Issue 3(2020)
• Publication Date: 2020-07
• Subjects: Multiple sclerosis -- natalizumab -- COVID-19 -- novel coronavirus disease -- cytokine storm syndrome -- IL-6 inhibitor; Multiple sclerosis -- Periodicals; 616.834
• DOI: 10.1177/2055217320942931
• Languages: English
• ISSNs: 2055-2173

Abstract

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.