Severe COVID-19 infection in a patient with multiple sclerosis treated with fingolimod
- 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.
Verfasserangaben: | Christian FörchORCiDGND, Lucie Friedauer, Boris Bauer, Timo WolfORCiDGND, Elisabeth AdamORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-547357 |
DOI: | https://doi.org/10.1016/j.msard.2020.102180 |
ISSN: | 2211-0348 |
Titel des übergeordneten Werkes (Englisch): | Multiple sclerosis and related disorders |
Verlag: | Elsevier |
Verlagsort: | Amsterdam [u.a.] |
Dokumentart: | Wissenschaftlicher Artikel |
Sprache: | Englisch |
Datum der Veröffentlichung (online): | 06.05.2020 |
Datum der Erstveröffentlichung: | 06.05.2020 |
Veröffentlichende Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Datum der Freischaltung: | 06.07.2020 |
Freies Schlagwort / Tag: | COVID-19; Critical care; Fingolimod; Multiple sclerosis; Viral infection |
Jahrgang: | 42 |
Ausgabe / Heft: | 102180 |
Seitenzahl: | 3 |
HeBIS-PPN: | 467705356 |
Institute: | Medizin / Medizin |
DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Lizenz (Deutsch): | ![]() |