Impact of mass vaccination on SARS-CoV-2 infections among the total multiple sclerosis population receiving immunomodulatory disease-modifying therapies in England

Evangelou, Nikos; Garjani, Alireza; Patel, Sameer; Bharkhada, Dhiren; Rashid, Waqar; Coles, Alasdair; Law, Graham

doi:10.21203/rs.3.rs-1016584/v1

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“…This result is supported by a recent study from England that compared the incidence risk ratio of SARS-CoV-2 infection between MS patients and the general population before and after mass vaccination. They found an increase in infection risk in MS patients treated with ocrelizumab, as an anti-CD20 agent, compared to the general population after vaccination [ 14 ]. A multi-center retrospective study from Italy showed a higher rate of SARS-CoV-2 mRNA Vaccine breakthrough infection in fully vaccinated MS patients on ocrelizumab and fingolimod than in patients treated with other DMTs [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Risk and severity of SARS-CoV-2 reinfection among patients with multiple sclerosis vs. the general population: a population-based study

et al. 2022

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Background We conducted this study to compare the risk of reinfection between multiple sclerosis (MS) patients and a control group without MS. Method In this retrospective study, data of all SARS-CoV-2 tests (n = 793,301) and almost all MS patients (n = 10,639) in Isfahan province were collected from January 01, 2020 to August 22, 2021. Of the 2196 MS patients and 793,301 persons from the general population who had been tested at least once, 3 control for each MS patient were identified, leaving 1560 MS patients and 4680 controls without MS. We compared the risk of reinfection after 90 days of a primary infection between those with and without a previous positive COVID-19 test. Results 736 (47.2%) MS patients and 2013 (43.0%) control individuals had at least one positive test. A total of 17 (2.3%) and 22 (1.1%) possible reinfections in MS and control groups were observed. The estimated protection against reinfection in all MS patients, MS patients on rituximab, MS patients on DMTs rather than rituximab, and controls were 68.2% (46.2, 81.2%), 57.4% (− 0.1, 83.1%), 71.5% (45.5, 85.2%), and 82.1% (72.1, 88.5%), respectively. We found no statistically significant difference in estimated protection (p = 0.123) and odd of reinfection (adjusted OR: 2.01 [0.98, 4.08]) between all MS patients and control group. Two patients were hospitalized at first infection but none required hospitalization at reinfection event. Conclusions MS patients on rituximab may be at a greater risk of reinfection. Further studies are required to assess the risk of the second reinfection among the MS population.

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Section: Discussionmentioning

confidence: 99%