Department of Neurology, Institute of Neurosciences, San Carlos Health Research Institute (IdISSC), Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
J Med Virol. 2021 Jan;93(1):546-549. doi: 10.1002/jmv.26279. Epub 2020 Jul 15.
The role of disease-modifying therapies in patients with autoimmune disorders during severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection is controversial. Immunocompromised patients could have a more severe coronavirus disease-2019 (COVID-19) due to the absence of an adequate immune response against the SARS-CoV-2. However, therapies that act on immune response could play a protective role by dampening the cytokine-release syndrome. Fingolimod is a drug used for immune therapy in patients with multiple sclerosis (MS) through the sequestration of activated lymphocytes in the lymph nodes. We report the case of a 57-year-old man with relapsing-remitting MS treated with fingolimod that showed a reactivation of COVID-19 with signs of hyperinflammation syndrome after fingolimod withdrawal. Our case suggests that discontinuation of fingolimod during COVID-19 could imply a worsening of SARS-CoV2 infection.
在严重急性呼吸综合征冠状病毒 2 (SARS-CoV2) 感染期间，疾病修饰疗法在自身免疫性疾病患者中的作用存在争议。由于缺乏针对 SARS-CoV-2 的充分免疫反应，免疫功能低下的患者可能会出现更严重的 2019 年冠状病毒病 (COVID-19)。然而，作用于免疫反应的疗法可以通过抑制细胞因子释放综合征发挥保护作用。芬戈莫德是一种用于多发性硬化症 (MS) 患者免疫治疗的药物，通过将活化的淋巴细胞隔离在淋巴结中。我们报告了一例使用芬戈莫德治疗的复发性缓解型多发性硬化症 57 岁男性，在停用芬戈莫德后出现 COVID-19 再激活，并伴有炎症综合征迹象。我们的病例表明，COVID-19 期间停用芬戈莫德可能意味着 SARS-CoV2 感染恶化。
