A clinical case of a severe course of the COVID-­19 in a patient with primary progressive multiple sclerosis

Abstract

Coronavirus disease-2019 (COVID-19), despite the emergence of new pathogen variants, remains the leading cause of acute respiratory viral infections and can be severe in patients with concomitant chronic diseases, including multiple sclerosis (MS). Increased risks of complicated COVID-19 were more often observed in elderly MS patients, males, those with significant physical activity limitations, and progressive disease. While the majority of patients in this category, according to the literature, were characterised by a mild course of COVID-19, even compared to the general population. There are reports that the prolonged quarantine that accompanied the coronavirus pandemic had a negative impact on patients with progressive MS by reducing patients’ physical activity, increasing body weight, and increasing the incidence of depression. Primary progressive MS patients account for about 15 % of all MS patients. They are characterised by a relatively rapid increase in disability and limitation of motor activity. The article presents a clinical case of severe coronavirus disease in an elderly patient with primary progressive MS. The authors note the wave-like course of the immunopathological stage of COVID-19, which was characterised by both the increase in signs of intoxication, fever and respiratory failure, and the prolonged preservation of elevated markers of the inflammatory process (C-reactive protein). Positive dynamics was obtained after prescribing intravenous immunoglobulins, but the patient’s motor activity was significantly limited, general weakness and fatigue increased, and the ability to care for oneself in bed remained. The patient lost the ability to independently move from the bed to the wheelchair.