Title: Recurrence of covid-19 in a patient with NMO spectrum disorder while treating with rituximab

Abstract

Introduction: In the context of coronavirus disease 2019 (COVID-19) pandemic, patients with neuromyelitisoptica spectrum disorder (NMOSD) are vulnerable to develop COVID-19 due to the immunosuppressive therapy. The objective of this study is to describe a known case of NMOSD on rituximab who experienced 2 episodes of COVID-19. Case Report: A 25-year-old woman, a known case of NMOSD on rituximab was diagnosed with asymptomatic COVID-19. Eight months later, following her last infusion of rituximab, she developed moderate COVID-19. After a partial recovery, she exhibited exacerbation of respiratory symptoms leading to readmission and invasive oxygenation. She was eventually discharged home after 31 days. Her monthly neurological evaluation did not reveal evidence of disease activity. She later received intravenous immunoglobulin and the decision was made to start rituximab again. Conclusions:Our case raises the possibility of persistent virus shedding and reactivation of severe acute respiratory syndrome coronavirus-2 in a patient with NMOSD and rituximab therapy. We aimed to emphasize a precise consideration of the management of patients with NMOSD during the COVID-19 pandemic.

Biography

Sepideh Paybast was born in 1988 in Iran. She passed the general medicine course at the University of ShahidBeheshti, Tehran, Iran, between 2007-and 2014. Then she took a specialized course in general neurology in 2014- 2018 at the University of ShahidBeheshti. After graduation, she started her job as an assistant professor of Neurology at the University of Qazvin (2019-2020) and subsequently Qom (2020-2021). While working in Qom, Iran, she was also a member of the research center of Qom universality of medical sciences, Iran, Afterward, she participated in the MS fellowship examination at the University of Tehran, Iran. Currently she is in the final half of my MS fellowship course, and she will graduate in the next six months. Her main research interest is devoted to central nervous system demyelinating disorders.