The COVID-19 pandemic was announced in 2020, and many professional medical societies had to review their algorithms for the management of high-risk patients. In addition to risk factors such as overweight, age over 65 years, cardiovascular disease, diabetes mellitus, and bronchial asthma, other chronic diseases should also be emphasized, taking into account possible immunosuppressive therapy. This publication presents two clinical cases of COVID-19 infection in patients with multiple sclerosis treated with ocrelizumab. During the course of the disease, both patients developed a cytokine storm and were treated with IL-6 blockers. Both cases ended with recovery and a subsequent return to anti-B-cell therapy. Given the mechanism of action of ocrelizumab, there are higher risks of infectious complications, including with COVID-19, but mortality is not higher than the population average. The information published to date may serve as a reason to consider the use of extended dosing intervals to minimize the possible risks of COVID-19 infection, which are probably highest in the first months after infusion.
Currently, the use of anticoagulants is a mandatory component of the complex therapy of COVID-19. Regarding the choice of drugs and their dosages, there is no consensus yet. Increasing doses reduces the risk of thrombosis, but at the same time increases the risk of bleeding, which is a common event in severe COVID-19. This makes it relevant to study alternative options for thromboprophylaxis. The aim of this study was to compare the efficacy and safety of oral sulodexide and dabigatran etexilate in patients with COVID-19. Sulodexide demonstrated the same clinical efficacy as dabigatran in the treatment of patients with a degree of lung damage not higher than CT-2, while the relief of the initially existing coagulopathy occurred significantly faster, and there was no excessive increase in thrombin time, characteristic of dabigatran.
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