It’s not just MS #mscovid19

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I haven’t done one of these for a while. The CoOVID-19 publication epidemic has continued at a rate of knots and there is lots of stuff to give us a laugh.

So you may not be surprised that COVID-19 in the UK and USA has made us rush to the drinks cabinet

Problem drinking before and during the COVID-19 crisis in US and UK adults: Evidence from two population-based longitudinal studies

Michael Daly, Eric Robinsondoi: https://doi.org/10.1101/2020.06.25.20139022

Whats this this got to do with MS..yet nothing and you may ask what has this got to do with MS….Well it is relevant to anti-CD20. It is interesting how it is seen in other conditions.

Several reports suggest a more prolonged disease in patients under rituximab, a B cell depleting drug.

Tepasse P-R, Hafezi W, Lutz M, Kühn J, Wilms C, Wiewrodt R, et al. Persisting SARS-CoV-2 viraemia after rituximab therapy: two cases with fatal outcome and a review of the literature. Br J Haematol. 1 juin 2020;2.

Avouac J, Airó P, Carlier N, Matucci-Cerinic M, Allanore Y. Severe COVID-19-associated pneumonia in 3 patients with systemic sclerosis treated with rituximab. Ann Rheum Dis. 5 juin 2020;

Guilpain P, Le Bihan C, Foulongne V, Taourel P, Pansu N, Maria ATJ, et al. Rituximab for granulomatosis with polyangiitis in the pandemic of covid-19: lessons from a case with severe pneumonia. Ann Rheum Dis. 20 avr 2020; Acce

Increased risk for severe COVID19 in patients with inflammatory rheumatic diseases treated with rituximab.Schulze-Koops H, Krueger K, Vallbracht I, Hasseli R, Skapenko A.Ann Rheum Dis. 2020 Jun 26:annrheumdis-2020-218075.

Whilst this is a letter about some people that died from COVID (both over 70 years old) It says “Our patients are not the unfortunate exceptions in that a substantial proportion of patients with inflammatory rheumatic diseases treated with rituximab require hospitalisation when infected with SARS-CoV-2 (eg, 67% of the patients in the National Registry for patients with IRD infected with SARS-CoV-2 in Germany) (Hasseli et al, submitted for publication, 2020)”.


Extending rituximab dosing intervals in patients with MS during the COVID19 pandemic and beyond?
Maarouf A, Rico A, Boutiere C, Perriguey M, Demortiere S, Pelletier J, Audoin B; Under the aegis of OFSEP.Neurol Neuroimmunol Neuroinflamm. 2020 Jun 25;7(5):e825. doi: 10.1212/NXI.0000000000000825. Print 2020 Sep.PMID: 32587103

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MouseDoctor

6 comments

  • It’s known that anti-CD20 drugs deplete B cells.
    It’s known that alcohol depresses bone marrow.
    It’s known that stem cells in bone marrow replete B cells.
    It is therefore logical deduce that alcohol diminishes B cell repopulation if you’re taking an anti-CD20 drug.
    What’s not known, as far as I know, is do people taking anti-CD20 drugs who still drink alcohol get more infections, experience a different clinical benefit against MS, need less frequent doses of their anti-CD20 or have lower B cell counts?
    I stopped drinking alcohol when I started Ocrelizumab and all I know for certain is that my GGT is consistently below the ‘normal range’, which suggests that the ‘normal’ is based on an alcohol drinking population,
    Alcohol is neurotoxic too and I want to keep all the neurones that I can.

    • They’ve found it in blood, urine and anal swabs. I have no idea why the researchers decided to do anal swabs. It’s highest concentrations are found in lung fluid, which is why Bronchoalveolar Lavage (BAL) provides the most sensitive test for CoVID-19 infection.

      • The highest level of ACE2 can be in the intestine and it is one of the signs…Researchers were swabbing everything but I also suspect it has something to do with the ethos of chinese medicine where stools can offer information

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