Q&A 41: To switch from ocrelizumab or not

I was admitted to the hospital and treated with antibiotics. Investigations revealed I had multiple pulmonary emboli. Should I stop ocrelizumab?

Case study

I am a 56-year-old man with MS for nearly 20 years. I have been on ocrelizumab for five years. Unfortunately, I had COVID early this year and was treated with Paxlovid. After two months of persistent respiratory symptoms, I developed rigors and a temperature. I was admitted to the hospital and treated with antibiotics. Investigations revealed I had multiple pulmonary emboli. I was found to be SARS-CoV2 positive; whether this was a second episode of COVID-19 or prolonged COVID-19 complicated by hypercoagulability and pulmonary emboli is a moot point. My pulmonologist favours the latter and suggests I stop ocrelizumab. What would you recommend? 

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Prof G’s opinion