奥瑞珠单抗治疗多发性硬化症患者合并 COVID-19：免疫抑制是否具有保护作用？
COVID-19 in a MS patient treated with ocrelizumab: does immunosuppression have a protective role?
机构信息
Department of Neuroscience, Ospedale Policlinico San Martino, IRCCS, Genova, Italy.
Department of Health Sciences (DISSAL), University of Genova, Genova, Italy; Ospedale Policlinico San Martino, IRCCS, Genova, Italy.
出版信息
Mult Scler Relat Disord. 2020 Jul;42:102120. doi: 10.1016/j.msard.2020.102120. Epub 2020 Apr 15.
BACKGROUND
Coronavirus disease 19 (COVID-19) is a novel disease entity that is spreading throughout the world. It has been speculated that patients with comorbidities and elderly patients could be at high risk for respiratory insufficiency and death. Immunosuppression could expose infected patients to even higher risks of disease complications due to dampened immune response. However, it has been speculated that overactive immune response could drive clinical deterioration and, based on this hypothesis, several immunosuppressants are currently being tested as potential treatment for COVID-19.
METHODS
In this paper we report on a patient that has been treated with ocrelizumab (a B-cell depleting monoclonal antibody) for primary progressive multiple sclerosis who developed COVID-19.
RESULTS
Despite complete B cell depletion, patient symptoms abated few days after hospitalization, and he was discharged to home-quarantine. Phone interview follow-up confirmed that, after 14 days, no new symptoms occurred.
DISCUSSION
This report supports the putative role of immunosuppressive therapy in COVID-19 affected patients.
背景
新型冠状病毒病（COVID-19）是一种在全球范围内传播的新型疾病实体。据推测，合并症患者和老年患者可能有发生呼吸功能不全和死亡的高风险。免疫抑制可能会使感染患者因免疫反应减弱而面临更高的疾病并发症风险。然而，据推测，过度活跃的免疫反应可能会导致临床恶化，基于这一假设，目前正在测试几种免疫抑制剂作为 COVID-19 的潜在治疗方法。
方法
在本文中，我们报告了一例接受奥瑞珠单抗（一种 B 细胞耗竭单克隆抗体）治疗原发性进行性多发性硬化症的患者，该患者感染了 COVID-19。
结果
尽管完全耗尽了 B 细胞，但患者的症状在住院后几天内减轻，随后出院进行居家隔离。电话随访确认，14 天后未出现新的症状。
讨论
本报告支持免疫抑制治疗在 COVID-19 受影响患者中的潜在作用。
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