key: cord-0808710-99k9ok9h authors: Ghajarzadeh, Mahsa; Mirmosayyeb, Omid; Barzegar, Mahdi; Nehzat, Nasim; Vaheb, Saeed; Shaygannejad, Vahid; Maghzi, Amir-Hadi title: Favorable Outcome After COVID-19 Infection in a Multiple Sclerosis Patient Initiated on Ocrelizumab During the Pandemic date: 2020-05-23 journal: Mult Scler Relat Disord DOI: 10.1016/j.msard.2020.102222 sha: 58e1130ff2c0cb4698aded666a45472630f2a65c doc_id: 808710 cord_uid: 99k9ok9h nan patients with COVID-19 (7 rituximab and 2 ocrelizumab) and none needed hospitalization. 2 However, only 4 patients (2 in each group) the virus was detected either by PCR or serology, and 5 are categorized as suspected. 2 A more recent pharmacovigilance study reported 100 MS patients treated with ocrelizumab with confirmed (n=74) or suspected (n=26) COVID-19 infection, of whom about a quarter were hospitalized (n=26) and 5 developed critical illness with no mortality (missing data n=7). 6 Here, we report another patients with relapsing-remitting MS who was initiated on ocrelizumab during the pandemic and developed COVID-19 as confirmed by polymerase chain reaction (PCR) and recovered without need for hospitalization. On April 6 and about 3 months after initiation of therapy, the patient developed a low-grade fever and she developed mild dyspnea the next day which prompted her to seek medical attention. Physical examination showed a body temperature of 37.5 C, blood pressure of 120/90 mm Hg, heart rate of 82, respiratory rate of 16, and oxygen saturation of 98% on room air and unchanged neurological exam as compared to prior visit in January 2020. Her initial lab investigations were remarkable for only slightly elevated in C-reactive protein (11.8 mg/L). She also reported her husband being diagnosed with COVID-19 who was admitted to the hospital for further care. A chest computed tomography (CT) was performed and showed patchy ground glass opacities on the base of right lung suggestive of COVID-19. 8 10 Of interest is that the husband of the patient who was otherwise healthy required hospitalization while the patient had very mild symptoms. These observations could support the notion that some forms of immunosuppression may be beneficial in the COVID-19 infection, although more controlled and randomized trial are needed to validate this observation. 1 In conclusion, emerging data about use of ocrelizumab during the COVID-19 pandemic is reassuring, however more studies with confirmed PCR or serology with larger samples size are required to confirm the current observations. Anti-CD20 immunosuppressive disease-modifying therapies and COVID-19 Anti-CD20 and COVID-19 in multiple sclerosis and related disorders: A case series of 60 patients from Madrid B-cell depleting therapies may affect susceptibility to acute respiratory illness among patients with Multiple Sclerosis during the early COVID-19 epidemic in Iran COVID-19 in a MS patient treated with ocrelizumab: does immunosuppression have a protective role? Benign course of COVID-19 in a multiple sclerosis patient treated with Ocrelizumab COVID-19 in persons with multiple sclerosis treated with ocrelizumab -a pharmacovigilance case series An Italian programme for COVID-19 infection in multiple sclerosis Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection COVID-19 infection in a patient with multiple sclerosis treated with fingolimod SARS-CoV-2 and Multiple Sclerosis: Not all immune depleting DMTs are equal or bad Funding: The study did not have any external funding.