key: cord-0075417-th5vf2gy
authors: nan
title: Ocrelizumab: Coronavirus disease-2019 : 15 case reports
date: 2022-03-05
journal: Reactions Weekly
DOI: 10.1007/s40278-022-11159-3
sha: 627cc06fd60106151beb0999bb75dd76763aafe7
doc_id: 75417
cord_uid: th5vf2gy

nan

specific treatment. Thereafter, she completely recovered.

Case 7: A 52-year-old woman developed COVID-19 infection during treatment with ocrelizumab for RR-MS. The woman, who was diagnosed with RR-MS in October 2005, had been previously treated with interferon-beta 1a. Due to evidence of disease activity, her treatment was switched to ocrelizumab in 2019. On 23 October 2020 (137 days after the last ocrelizumab cycle), she developed cough, shortness of breath, fever, ageusia and anosmia. On 25 October 2020, the nasopharyngeal swab test was found to be positive. Based on the clinical presentation and laboratory findings, COVID-19 infection secondary to the ocrelizumab therapy was considered. Therefore, she received an off-label treatment with amoxicillin and prednisone. Due to mild symptoms, she was self-quarantined at home. Over the following weeks, she recovered completely except for a persisting anosmia and ageusia. On 16 November 2020, the nasal swab test was found to be negative. In February 2021, a quantitative serological test showed the presence of IgG against SARS-CoV2.

Case 8: A 50-year-old woman developed COVID-19 infection during treatment with ocrelizumab for RR-MS. The woman, who was diagnosed with RR-MS in 2015, had been previously treated with teriflunomide and natalizumab. On 16 September 2019, her treatment was switched to ocrelizumab due to the persistence of disease activity. She received the last cycle of ocrelizumab on 01 October 2020. On 27 October 2020 (26 days after the last ocrelizumab cycle), she developed headache, fever, nasal congestion, ageusia and hyposmia. After a few days, a nasal swab was performed, which confirmed the diagnosis of COVID-19 infection secondary to the ocrelizumab therapy. Therefore, she received an off-label treatment with amoxicillin and unspecified steroid therapy. As a result, she recovered gradually without the need for hospitalisation.

Case 9: A 52-year-old woman developed COVID-19 infection during treatment with ocrelizumab for RR-MS. The woman was diagnosed with RR-MS in 2019. On 23 May 2019, she started receiving treatment with ocrelizumab. On 23 October 2020 (136 days after the last ocrelizumab cycle), she developed fatigue, fever and bone pain. Based on the clinical presentation and laboratory findings, COVID-19 infection secondary to the ocrelizumab therapy was considered. She recovered rapidly without any treatment over the following days. On 28 October 2020 and 11 November 2020, the nasal swab tests were found to be positive; however, she was tested negative on 27 January 2021.

Case 10: A 58-year-old woman developed COVID-19 infection during treatment with ocrelizumab for PP-MS. The woman, who was diagnosed with PP-MS in 2014, had been previously treated with interferon-beta 1a. Her medical history was significant for obesity and Graves' disease. In September 2018, she started receiving treatment with ocrelizumab. On 18 August 2020, she received the fourth cycle of ocrelizumab. On 09 December 2020 (113 days after the last ocrelizumab cycle), during a hospitalisation in a rehabilitation facility, she developed cough, vomiting and high fever. The nasal swab test was found to be positive for SARS-CoV2. Based on the clinical presentation and laboratory findings, COVID-19 infection secondary to the ocrelizumab therapy was considered. She was immediately transferred to a dedicated ward and received an off-label treatment with unspecified steroids and antibacterials [antibiotics] for 3 weeks. Due to hypoxaemia, she additionally required oxygen support. She gradually and completely recovered over the following weeks. On 20 January 2021, the nasal swab test was found to be negative.

Case 11: A 62-year-old man developed COVID-19 infection during treatment with ocrelizumab for RR-MS. The man, who was diagnosed with RR-MS, had been previously treated with natalizumab and interferon-beta 1a. His medical history was significant for benign prostatic hyperplasia. In April 2019, his treatment was switched to ocrelizumab. On 04 January 2021, the nasal swab test was found to be positive. On 08 January 2021 (22 days after the last ocrelizumab cycle), he developed nasal congestion, cough and fever. On 20 January 2021, he was admitted to the hospital due to the worsening of symptoms and the appearance of dyspnoea. Based on the clinical presentation and laboratory findings, COVID-19 infection secondary to the ocrelizumab therapy was considered. Therefore, he received an off-label treatment with unspecified steroids, antibacterials [antibiotics] and low molecular weight heparins. Due to worsening of respiratory exchanges, he underwent non-invasive ventilation. Over the following days, his symptoms remained stable; however, he had dyspnoea and worsening of neurological symptoms as COVID-19 sequelae. On 04 February 2021, the nasal swab test was found to be negative.

Case 12: A 40-year-old woman developed COVID-19 infection during treatment with ocrelizumab for RR-MS. The woman, who was diagnosed with RR-MS in 2008, had been previously treated with natalizumab and fingolimod. Due to the persistent disease activity, her treatment was switched to ocrelizumab in February 2019. On 14 February 2021 (125 days after the last ocrelizumab cycle), she developed fever (39.5°C), headache, cough, shortness of breath, nausea, nasal congestion and lymph nodes enlargement. On the next day, the nasal swab test was found to be positive for SARS-CoV2. Over the following weeks, she gradually recovered with a persistent headache, cough and thoracic pain. After 2 months, she underwent a chest X-ray, which revealed thickened bronchovascular markings. Based on the clinical presentation and laboratory findings, COVID-19 infection secondary to the ocrelizumab therapy was considered. Therefore, she received an off-label treatment with unspecified steroid and antibacterial [antibiotic] . As a result, she recovered completely over the following weeks; however, she still had cough, headache and dyspnoea as COVID-19 sequelae. On 05 May 2021, she received her fifth cycle of ocrelizumab. On 01 June 2021, a serological test was performed, which detected the presence of IgG antibodies against SARS-CoV2.

Case 13: A 53-year-old woman developed COVID-19 infection during treatment with ocrelizumab for RR-MS. The woman, who was diagnosed with RR-MS in 2008, had been previously treated with natalizumab, mitoxantrone and interferon-beta 1a. Her medical history was significant for hepatitis-B viral infection. On 13 February 2019, her treatment was switched to ocrelizumab. On 22 March 2021 (22 days after the last ocrelizumab cycle), she developed sore throat, fatigue, shortness of breath, headache and loss of taste. The nasal swab test was found to be positive for SARS-CoV2. Based on the clinical presentation and laboratory findings, COVID-19 infection secondary to the ocrelizumab therapy was considered. Over the following days, her oxygen blood saturation dropped below 90%. Therefore, she received oxygen therapy for 10 days. She received an off-label treatment with paracetamol and unspecified steroid therapy. As a result, she recovered completely over the following days. On 16 April 2021, the nasal swab test was found to be negative.

Case 14: A 54-year-old man developed COVID-19 infection during treatment with ocrelizumab for RR-MS. The man was diagnosed with RR-MS in January 2021. His medical history was significant for hypertension. On 28 January 2021, he received his first cycle of ocrelizumab. On 01 April 2021 (48 days after the last ocrelizumab cycle), he developed headache, leg stiffness, fever (40°C) and loss of smell and taste. On the next day, the nasal swab test was found to be positive. Based on the clinical presentation and laboratory findings, COVID-19 infection secondary to the ocrelizumab therapy was considered. Therefore, he received an offlabel treatment with unspecified steroid and antibacterial [antibiotic] therapy. On 06 May 2021, the nasal swab test was found to be negative; however, he did not recover completely. He was still symptomatic with increased fatigue, persisting reduction of taste (ipogeusia) and leg stiffness.

Case 15: A 33-year-old woman developed COVID-19 infection during treatment with ocrelizumab for MS. The woman, who had MS for a duration of 10 years, had been previously treated with natalizumab, fingolimod and alemtuzumab. Her medical history was significant for hyperthyroidism. On 16 October 2019, her treatment was switched to ocrelizumab. On 20 November 2020, she received her last cycle of ocrelizumab. Approximately 6 months later (184 days after the last ocrelizumab cycle), she developed

the nasal swab test was found to be positive. Based on the clinical presentation and laboratory findings, COVID-19 infection secondary to the ocrelizumab therapy was considered. Therefore, she received an off-label treatment with heparin and unspecified antibacterial

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