tetano
Editor, Senior Moderator
Mult Scler
. 2024 Nov 9:13524585241297038.
doi: 10.1177/13524585241297038. Online ahead of print. Secondary organising pneumonia associated to COVID-19 infection in patients with central nervous system inflammatory demyelinating diseases treated with anti-CD20 therapies
René Carvajal[SUP] 1 [/SUP], Breogán Rodríguez-Acevedo[SUP] 1 [/SUP], Lorena García-Vasco[SUP] 2 [/SUP], Ana Zabalza[SUP] 1 [/SUP], Helena Ariño[SUP] 1 [/SUP], Luca Bollo[SUP] 1 [/SUP], Noemí Cabello-Clotet[SUP] 3 [/SUP], Joaquín Castilló[SUP] 1 [/SUP], Álvaro Cobo-Calvo[SUP] 1 [/SUP], Manuel Comabella[SUP] 1 [/SUP], Anna Falcó-Roget[SUP] 4 [/SUP], Ingrid Galán[SUP] 1 [/SUP], Alexis García-Sarreón[SUP] 1 [/SUP], Irene Gómez-Estévez[SUP] 2 [/SUP], Galo Granados[SUP] 5 [/SUP], Delon La Puma[SUP] 1 [/SUP], Gloria Mato Chain[SUP] 6 [/SUP], Luciana Midaglia[SUP] 1 [/SUP], Asunción Nieto-García[SUP] 7 [/SUP], Susana Otero-Romero[SUP] 8 9 [/SUP], Agustín Pappolla[SUP] 1 [/SUP], Marta Rodriguez[SUP] 1 [/SUP], Irene Sansano[SUP] 10 [/SUP], Jordi Río[SUP] 1 [/SUP], Paula Tagliani[SUP] 1 [/SUP], Carmen Tur[SUP] 1 [/SUP], Ángela Vidal-Jordana[SUP] 1 [/SUP], Andreu Vilaseca[SUP] 1 [/SUP], Ana Villar[SUP] 5 [/SUP], Jaume Sastre-Garriga[SUP] 1 [/SUP], Celia Oreja-Guevara[SUP] 2 11 [/SUP], Mar Tintoré[SUP] 8 12 [/SUP], Xavier Montalban[SUP] 8 12 [/SUP], Georgina Arrambide[SUP] 1 [/SUP]
Affiliations
Background: Organizing pneumonia (OP), an interstitial lung disease, has been observed in patients with inflammatory demyelinating diseases (IDDs) treated with anti-CD20, particularly after COVID-19, but data are limited.
Aim: To provide a detailed characterization of COVID-19-associated OP in IDD patients treated with anti-CD20.
Methods: Bi-centric retrospective cohort study including patients with multiple sclerosis (MS), aquaporin-4-positive neuromyelitis optica spectrum disorder (AQP4 + NMOSD), and myelin oligodendrocyte glycoprotein antibody disease (MOGAD) who received anti-CD20 and were diagnosed with COVID-19-associated OP between March 2020 and October 2023.
Results: Nineteen patients were included (mean age 46.8 years; 52.6% female; 63% rituximab, 37% ocrelizumab). Sixteen had MS, two MOGAD, and one AQP4 + NMOSD. Intermittent fever was the predominant symptom. Hospitalization occurred in all but one patient, without fatalities. Chest CT consistently showed OP patterns. Thirteen patients had positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR in bronchoalveolar lavage. Treatments included corticosteroids, antivirals, monoclonal antibodies, and convalescent plasma. Fourteen patients postponed infusions; nine resumed post-recovery (median 11.9 months), two switched due to hypogammaglobulinemia, and three stopped. After a mean follow-up of 1.5 years, lung abnormalities and clinical manifestations resolved in 18 patients; however, 13 experienced long-COVID.
Conclusions: In anti-CD20-treated patients with recurrent fever and distinctive CT features, COVID-19-associated OP should be considered.
Keywords: Multiple sclerosis; neuromyelitis optica (NMO).
. 2024 Nov 9:13524585241297038.
doi: 10.1177/13524585241297038. Online ahead of print. Secondary organising pneumonia associated to COVID-19 infection in patients with central nervous system inflammatory demyelinating diseases treated with anti-CD20 therapies
René Carvajal[SUP] 1 [/SUP], Breogán Rodríguez-Acevedo[SUP] 1 [/SUP], Lorena García-Vasco[SUP] 2 [/SUP], Ana Zabalza[SUP] 1 [/SUP], Helena Ariño[SUP] 1 [/SUP], Luca Bollo[SUP] 1 [/SUP], Noemí Cabello-Clotet[SUP] 3 [/SUP], Joaquín Castilló[SUP] 1 [/SUP], Álvaro Cobo-Calvo[SUP] 1 [/SUP], Manuel Comabella[SUP] 1 [/SUP], Anna Falcó-Roget[SUP] 4 [/SUP], Ingrid Galán[SUP] 1 [/SUP], Alexis García-Sarreón[SUP] 1 [/SUP], Irene Gómez-Estévez[SUP] 2 [/SUP], Galo Granados[SUP] 5 [/SUP], Delon La Puma[SUP] 1 [/SUP], Gloria Mato Chain[SUP] 6 [/SUP], Luciana Midaglia[SUP] 1 [/SUP], Asunción Nieto-García[SUP] 7 [/SUP], Susana Otero-Romero[SUP] 8 9 [/SUP], Agustín Pappolla[SUP] 1 [/SUP], Marta Rodriguez[SUP] 1 [/SUP], Irene Sansano[SUP] 10 [/SUP], Jordi Río[SUP] 1 [/SUP], Paula Tagliani[SUP] 1 [/SUP], Carmen Tur[SUP] 1 [/SUP], Ángela Vidal-Jordana[SUP] 1 [/SUP], Andreu Vilaseca[SUP] 1 [/SUP], Ana Villar[SUP] 5 [/SUP], Jaume Sastre-Garriga[SUP] 1 [/SUP], Celia Oreja-Guevara[SUP] 2 11 [/SUP], Mar Tintoré[SUP] 8 12 [/SUP], Xavier Montalban[SUP] 8 12 [/SUP], Georgina Arrambide[SUP] 1 [/SUP]
Affiliations
- PMID: 39520297
- DOI: 10.1177/13524585241297038
Background: Organizing pneumonia (OP), an interstitial lung disease, has been observed in patients with inflammatory demyelinating diseases (IDDs) treated with anti-CD20, particularly after COVID-19, but data are limited.
Aim: To provide a detailed characterization of COVID-19-associated OP in IDD patients treated with anti-CD20.
Methods: Bi-centric retrospective cohort study including patients with multiple sclerosis (MS), aquaporin-4-positive neuromyelitis optica spectrum disorder (AQP4 + NMOSD), and myelin oligodendrocyte glycoprotein antibody disease (MOGAD) who received anti-CD20 and were diagnosed with COVID-19-associated OP between March 2020 and October 2023.
Results: Nineteen patients were included (mean age 46.8 years; 52.6% female; 63% rituximab, 37% ocrelizumab). Sixteen had MS, two MOGAD, and one AQP4 + NMOSD. Intermittent fever was the predominant symptom. Hospitalization occurred in all but one patient, without fatalities. Chest CT consistently showed OP patterns. Thirteen patients had positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR in bronchoalveolar lavage. Treatments included corticosteroids, antivirals, monoclonal antibodies, and convalescent plasma. Fourteen patients postponed infusions; nine resumed post-recovery (median 11.9 months), two switched due to hypogammaglobulinemia, and three stopped. After a mean follow-up of 1.5 years, lung abnormalities and clinical manifestations resolved in 18 patients; however, 13 experienced long-COVID.
Conclusions: In anti-CD20-treated patients with recurrent fever and distinctive CT features, COVID-19-associated OP should be considered.
Keywords: Multiple sclerosis; neuromyelitis optica (NMO).