BACKGROUND We reported a case of multiple sclerosis (MS) with persistent symptomatic COVID-19 which was complicated by new-appearing severe pneumonia 40 days after disease onset. CASE PRESENTATION A 38-year-old man with history of multiple sclerosis referred to our hospital with fever, shaking chills, cough and dyspnea. In his history, the patient had developed mild COVID-19 from 40 days ago. After 7 days of disease onset, the COVID symptoms had been subsided partially but fatigue, myalgia, intermittent fever and loss of taste and smell had been continued. In physical examinations, his oral temperature was 39.4 °C. He had respiratory distress and his blood oxygen saturation on the room air was 90%. The spiral chest CT scan was performed which revealed bilateral ground glass and alveolar opacities in favor of COVID-19 pneumonia. The result of RT-PCR test for SARS-COV-2 was reported positive, subsequently. His current MS medication was rituximab and he had received the last dose of rituximab, two months before developing COVID-19. The patient was admitted to COVID ward and put on Remdesivir, subcutaneous interferon-beta1b and dexamethasone. He improved gradually and was discharged from the hospital with favorable condition after 10 days. This patient had a rare protracted disease course. We presumed that prolong high degree fever (above 38 °C) in our patient is beyond the diagnosis of post-COVID-19 syndrome and is more compatible with persistent infection. CONCLUSION Although, most immunocompromised patients effectively clear SARS-CoV-2 infection, but this case report highlights the risk of persistent infection associated with recurrence of disease.
A case of multiple sclerosis with protracted course of COVID-19.