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
Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Multiple Sclerosis Center and Center for Translational and Computational Neuroimmunology, Columbia University Irving Medical Center, United States of America.
New York Presbyterian Hospital, United States of America.
Mult Scler J Exp Transl Clin. 2020 Aug 10;6(3):2055217320942931. doi: 10.1177/2055217320942931. eCollection 2020 Jul-Sep.
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.
我们报告了一例51岁患有多发性硬化症且正在使用那他珠单抗治疗的非裔美国女性新冠肺炎死亡病例。她有多种导致严重新冠肺炎疾病的风险因素，包括种族、肥胖、高血压和炎症标志物升高，但那他珠单抗对其不良预后的影响尚不清楚。我们考虑在那他珠单抗治疗背景下外周免疫细胞动力学的改变是否会加重与严重新冠肺炎相关的细胞因子风暴综合征。我们讨论了延长给药间隔作为那他珠单抗治疗的多发性硬化症患者降低风险的策略，以及在感染新冠肺炎的此类患者中使用白细胞介素-6抑制剂的情况。
