Long COVID in Patients with Multiple Sclerosis Treated with Rituximab: A Report of Two Cases

Tabarsi, Payam; Mohamadnia, Abdolreza; Shahabinejad, Pardis; Haseli, Sara; Askari, Elham; Bahrami, Naghmeh; Shafaghi, Shadi; Hajimoradi, Maryam

Long COVID in Patients with Multiple Sclerosis Treated with Rituximab: A Report of Two Cases

Document Type : Case Report

Authors

Payam Tabarsi ¹

Abdolreza Mohamadnia ²

Pardis Shahabinejad ³

Sara Haseli ²

Elham Askari ²

Naghmeh Bahrami ⁴

Shadi Shafaghi ⁵

Maryam Hajimoradi ⁵

¹ Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

² Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran

³ School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

⁴ Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

⁵ Lung Transplantation Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

COVID-19 symptoms may persist for more than 12 weeks in some infected patients, a condition described as long COVID-19 in these cases. These patients have symptoms attributed to impairment of multiple organs. Scientists have discovered the lengthy COVID-19 etiology, risk factors, and treatments. It has been observed that immunosuppression may prolong COVID-19 symptoms. Patients with multiple sclerosis (pwMS) are generally treated with disease-modifying treatments, which suppress the immune system and predispose patients to infections like COVID-19. Also, these drugs may increase not only the morbidity and mortality of infection but also the risk of developing long COVID-19 in these patients. We have described two cases of multiple sclerosis patients who were diagnosed with long COVID-19. Both patients were under treatment with rituximab, so we discussed treatment choices and strategies for pwMS patients under rituximab who had symptoms of long COVID. Our data would further add to the information on managing long COVID-19 in pwMS under treatment with rituximab.

Keywords

COVID-19

long COVID

multiple sclerosis

rituximab

post-COVID syndrome

Subjects