TY - JOUR
T1 - Secondary organising pneumonia associated to COVID-19 infection in patients with central nervous system inflammatory demyelinating diseases treated with anti-CD20 therapies
AU - Carvajal, René
AU - Rodríguez-Acevedo, Breogán
AU - García-Vasco, Lorena
AU - Zabalza, Ana
AU - Ariño, Helena
AU - Bollo, Luca
AU - Cabello-Clotet, Noemí
AU - Castilló, Joaquín
AU - Cobo-Calvo, Álvaro
AU - Comabella, Manuel
AU - Falcó-Roget, Anna
AU - Galán, Ingrid
AU - García-Sarreón, Alexis
AU - Gómez-Estévez, Irene
AU - Granados, Galo
AU - La Puma, Delon
AU - Mato Chain, Gloria
AU - Midaglia, Luciana
AU - Nieto-García, Asunción
AU - Otero-Romero, Susana
AU - Pappolla, Agustín
AU - Rodriguez, Marta
AU - Sansano, Irene
AU - Río, Jordi
AU - Tagliani, Paula
AU - Tur, Carmen
AU - Vidal-Jordana, Ángela
AU - Vilaseca, Andreu
AU - Villar, Ana
AU - Sastre-Garriga, Jaume
AU - Oreja-Guevara, Celia
AU - Tintoré, Mar
AU - Montalban, Xavier
AU - Arrambide, Georgina
PY - 2024/12
Y1 - 2024/12
N2 - 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.
AB - 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.
KW - Multiple sclerosis
KW - Neuromyelitis optica (NMO)
UR - http://www.scopus.com/inward/record.url?scp=85208795625&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/a2343418-02b5-36cd-8e6f-0c3273a985de/
U2 - 10.1177/13524585241297038
DO - 10.1177/13524585241297038
M3 - Article
C2 - 39520297
SN - 1352-4585
VL - 30
SP - 1788
EP - 1801
JO - Multiple sclerosis (Houndmills, Basingstoke, England)
JF - Multiple sclerosis (Houndmills, Basingstoke, England)
IS - 14
ER -