Incidence and Impact of COVID-19 in MS

Sepúlveda, María; Llufriú, Sara; Martínez‐Hernández, Eugenia; Català, Martí; Artola, Montse; Hernando, Ana; Montejo, Carmen; Pulido-Valdeolivas, Irene; Martínez‐Heras, Eloy; Guasp, Mar; Solana, Elisabeth; Llansó, Laura; Escudero, Domingo; Aldea, Marta; Prats, Clara; Graus, Francesc; Blanco, Yolanda; Sáiz, Albert

doi:10.1212/nxi.0000000000000954

Cited by 34 publications

(19 citation statements)

References 16 publications

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“…The incidence of COVID-19 in people with MS ranges from below 1% to 11% (including suspected but not confirmed cases) in studies that included a cross-sectional mixed method study, retrospective cohort analysis, and a prospective observational cohort study compared with World Health Organization (WHO) estimates of 1432 per 100,000 globally, and 8424 per 100,000 in the USA in the general population [ 23 – 26 ]. COVID-19-related MS mortality has been reported to be approximately 1–4% overall (compared with a case–fatality ratio in the general population of 0.0–9.2% in the 20 countries most affected by COVID-19, including the USA, which has a rate of 1.8% [according to Johns Hopkins University]), and more than 50% of deaths have occurred in people not receiving MS DMTs [ 27 – 29 ].…”

Section: Introductionmentioning

confidence: 99%

Vaccine Considerations for Multiple Sclerosis in the COVID-19 Era

et al. 2021

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People with multiple sclerosis (MS) are at risk for infections that can result in amplification of baseline symptoms and possibly trigger clinical relapses. Vaccination can prevent infection through the activation of humoral and cellular immune responses. This is particularly pertinent in the era of emerging novel vaccines against severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). MS disease-modifying therapies (DMTs), which affect the immune system, may impact immune responses to COVID-19 vaccines in people with MS. The objective of this article is to provide information on immune system responses to vaccinations and review previous studies of vaccine responses in people with MS to support the safety and importance of receiving currently available and emerging COVID-19 vaccines. Immunological studies have shown that coordinated interactions between T and B lymphocytes of the adaptive immune system are key to successful generation of immunological memory and production of neutralizing antibodies following recognition of vaccine antigens by innate immune cells. CD4 + T cells are essential to facilitate CD8 + T cell and B cell activation, while B cells drive and sustain T cell memory. Data suggest that some classes of DMT, including type 1 interferons and glatiramer acetate, may not significantly impair the response to vaccination. DMTs—such as sphingosine-1-phosphate receptor modulators, which sequester lymphocytes from circulation; alemtuzumab; and anti-CD20 therapies, which rely on depleting populations of immune cells—have been shown to attenuate responses to conventional vaccines. Currently, three COVID-19 vaccines have been granted emergency use authorization in the USA on the basis of promising interim findings of ongoing trials. Because analyses of these vaccines in people with MS are not available, decisions regarding COVID-19 vaccination and DMT choice should be informed by data and expert consensus, and personalized with considerations for disease burden, risk of infection, and other factors.

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Section: Introductionmentioning

confidence: 99%

Vaccine Considerations for Multiple Sclerosis in the COVID-19 Era

et al. 2021

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“…The initial observational studies also suggest that patients with MS treated with DMTs are generally not at greater risk of severe COVID-19 infection [22][23][24][25]. However, in an Iranian MS cohort, the incidence of COVID-19 was comparable to the general population, but the hospitalisation rate was significantly higher [26].…”

Section: Discussionmentioning

confidence: 98%

Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies — the Polish experience

Czarnowska

Brola

Zajkowska

et al. 2021

Neurol Neurochir Pol.

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“…Multiple Sclerosis (MS) patients often have several other diseases, which are associated with a worse prognosis of COVID-19. The incidence of COVID-19 in MS patients was higher than that of the general population; however, they had a good outcome ( Sepúlveda et al, 2021 ).…”

Section: 1 Prevalence Of Gwas-annotated Snps Of the Ace2 Hla And Erap Genesmentioning

confidence: 94%

Relevance between COVID-19 and host genetics of immune response

Taher

Almaeen

Ghazy

et al. 2021

Saudi Journal of Biological Sciences

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The outbreak of coronavirus disease 2019 (COVID-19) was caused by the newly emerged corona virus (2019-nCoV alias SARS-CoV-2) that resembles the severe acute respiratory syndrome virus (SARS-CoV). SARS-CoV-2, which was first identified in Wuhan (China) has spread globally, resulting in a high mortality worldwide reaching ∼4 million deaths to date. As of first week of July 2021, ∼181 million cases of COVID-19 have been reported. SARS-CoV-2 infection is mediated by the binding of virus spike protein to Angiotensin Converting Enzyme 2 (ACE2). ACE2 is expressed on many human tissues; however, the major entry point is probably pneumocytes, which are responsible for synthesis of alveolar surfactant in lungs. Viral infection of pneumocytes impairs immune responses and leads to, apart from severe hypoxia resulting from gas exchange, diseases with serious complications. During viral infection, gene products (e.g. ACE2) that mediate viral entry, antigen presentation, and cellular immunity are of crucial importance. Human leukocyte antigens (HLA) I and II present antigens to the CD8 + and CD4 + T lymphocytes, which are crucial for immune defence against pathogens including viruses. HLA gene variants affect the recognition and presentation of viral antigenic peptides to T-cells, and cytokine secretion. Additionally, endoplasmic reticulum aminopeptidases (ERAP) trim antigenic precursor peptides to fit into the binding groove of MHC class I molecules. Polymorphisms in ERAP genes leading to aberrations in ERAP’s can alter antigen presentation by HLA class I molecules resulting in aberrant T-cell responses, which may affect susceptibility to infection and/or activation of immune response. Polymorphisms from these genes are associated, in global genetic association studies, with various phenotype traits/disorders some of which are related to the pathogenesis and progression of COVID-19; polymorphisms from various genes are annotated in genotype-tissue expression data as regulating the expression of ACE2, HLA’s and ERAP’s. We review such polymorphisms and illustrate variations in their allele frequencies in global populations. These reported findings highlight the roles of genetic modulators (e.g. genotype changes in ACE2 , HLA ’s and ERAP ’s leading to aberrations in the expressed gene products or genotype changes at other genes regulating the expression levels of these genes) in the pathogenesis of viral infection.

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Incidence and Impact of COVID-19 in MS

Cited by 34 publications

References 16 publications

Vaccine Considerations for Multiple Sclerosis in the COVID-19 Era

Vaccine Considerations for Multiple Sclerosis in the COVID-19 Era

Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies — the Polish experience

Relevance between COVID-19 and host genetics of immune response

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