Seroprevalence of SARS-CoV-2 in a Cohort of Patients with Multiple Sclerosis under Disease-Modifying Therapies

Sancho-Saldaña, Agustín; Gil-S, Anna; Quirant‐Sánchez, Bibiana; Nogueras, Lara; Peralta, Sílvia; Solana, María José; González-Mingot, Cristina; Gallego, Yhovany; Quibus, Laura; Ramo-Tello, Cristina; Presas-Rodríguez, Silvia; Martínez-Cáceres, Eva; Torres, Pascual; Hervás, José Vicente; Valls, Joan; Brieva, Luís

doi:10.3390/jcm11092509

Cited by 3 publications

(4 citation statements)

References 38 publications

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“…Regarding DMTs, PwMS treated with Interferon were significantly associated with a higher rate of seropositivity; this confirmed our previous findings from a single centre report [22]. This could be explained with Interferon having less effect on the humoral im-mune system, resulting in a more appropriate serological response rather than an increased risk of COVID-19 infection.…”

Section: Discussionsupporting

confidence: 88%

Seroprevalence of SARS-CoV-2 in Patients with Multiple Sclerosis under Disease-Modifying Therapies: A Multi-Centre Study

Sancho-Saldaña,

Gil-Sánchez,

González-Mingot

et al. 2023

JCM

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Background: The EMCOVID project conducted a multi-centre cohort study to investigate the impact of COVID-19 on patients with Multiple Sclerosis (pwMS) receiving disease-modifying therapies (DMTs). The study aimed to evaluate the seroprevalence and persistence of SARS-CoV-2 antibodies in MS patients enrolled in the EMCOVID database. The DMTs were used to manage MS by reducing relapses, lesion accumulation, and disability progression. However, concerns arose regarding the susceptibility of pwMS to COVID-19 due to potential interactions between SARS-CoV-2 and the immune system, as well as the immunomodulatory effects of DMTs. Methods: This prospective observational study utilized data from a Multiple Sclerosis and COVID-19 (EMCOVID-19) study. Demographic characteristics, MS history, laboratory data, SARS-CoV-2 serology, and symptoms of COVID-19 were extracted for pwMS receiving any type of DMT. The relationship between demographics, MS phenotype, DMTs, and COVID-19 was evaluated. The evolution of SARS-CoV-2 antibodies over a 6-month period was also assessed. Results: The study included 709 pwMS, with 376 patients providing samples at the 6-month follow-up visit. The seroprevalence of SARS-CoV-2 antibodies was higher among pwMS than the general population, with Interferon treatment being significantly associated with greater seroprevalence (16.9% vs. 8.4%; p 0.003). However, no other specific DMT showed a significant association with antibody presence. A total of 32 patients (8.5%) tested positive for IgG, IgM, or IgA antibodies against SARS-CoV-2 at baseline, but then tested negative at 6 months. Most of the pwMS in the cohort were asymptomatic for COVID-19 and, even among symptomatic cases, the prognosis was generally favourable. Conclusion: pwMS undergoing DMTs exhibited a higher seroprevalence of COVID-19 than the general population. Interferon treatment was associated with a higher seroprevalence, suggesting a more robust humoral response. This study provides valuable insights into the seroprevalence and persistence of SARS-CoV-2 antibodies in pwMS and contributes to our understanding of the impact of COVID-19 amongst this population.

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Section: Discussionsupporting

confidence: 88%

Seroprevalence of SARS-CoV-2 in Patients with Multiple Sclerosis under Disease-Modifying Therapies: A Multi-Centre Study

Sancho-Saldaña,

Gil-Sánchez,

González-Mingot

et al. 2023

JCM

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“…However, in the previous study, severity was no different from in the general population. Interestingly, interferon intake was significantly associated with the presence of a greater presence of SARS-CoV-2 antibodies, which was probably due to a better anti-viral response [ 5 ]. Notwithstanding this, an independent group found an increased risk of severe COVID-19 in pwMS when they were treated with an anti-CD20 agent (ocrelizumab or rituximab) DMT [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

A prospective study of cellular immune response to booster COVID-19 vaccination in multiple sclerosis patients treated with a broad spectrum of disease-modifying therapies

et al. 2023

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Background Most people with Multiple Sclerosis (pwMS) are subjected to immunomodulatory disease-modifying treatments (DMTs). As a result, immune responses to COVID-19 vaccinations could be compromised. There are few data on cellular immune responses to the use of COVID-19 vaccine boosters in pwMS under a broad spectrum of DMTs. Methods In this prospective study, we analysed cellular immune responses to SARS-CoV-2 mRNA booster vaccinations in 159 pwMS with DMT, including: ocrelizumab, rituximab, fingolimod, alemtuzumab, dimethyl fumarate, glatiramer acetate, teriflunomide, natalizumab and cladribine. Results DMTs, and particularly fingolimod, interact with cellular responses to COVID-19 vaccination. One booster dose does not increase cellular immunity any more than two doses, except in the cases of natalizumab and cladribine. SARS-CoV-2 infection combined with two doses of vaccine resulted in a greater cellular immune response, but this was not observed after supplementary booster jabs. Ocrelizumab-treated pwMS who had previously received fingolimod did not develop cellular immunity, even after receiving a booster. The time after MS diagnosis and disability status negatively correlated with cellular immunity in ocrelizumab-treated pwMS in a booster dose cohort. Conclusions After two doses of SARS-CoV-2 vaccination, a high response yield was achieved, except in patients who had received fingolimod. The effects of fingolimod on cellular immunity persisted for more than 2 years after a change to ocrelizumab (which, in contrast, conserved cellular immunity). Our results confirmed the need to find alternative protective measures for fingolimod-treated people and to consider the possible failure to provide protection against SARS-CoV-2 when switching from fingolimod to ocrelizumab.

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“…There are already some reports, although limited, on certain DMTs affecting seroconversion after SARS-CoV-2 infection, in pwMS [ 106 , 107 ]. In general, the administration of IFN-β has been significantly associated with the presence of antibodies against SARS-CoV-2, after infection with the virus [ 108 ]. In this sense, Bigaut et al (2021) found that pwMS treated with IFN-β1a or Glatiramer Acetate had an anti-SARS-CoV-2 IgG index higher than that of patients treated with Fingolimod or anti-CD20 therapies [ 109 ].…”

Section: Interaction Covid-19 and Multiple Sclerosismentioning

confidence: 99%

“…In this sense, Bigaut et al (2021) found that pwMS treated with IFN-β1a or Glatiramer Acetate had an anti-SARS-CoV-2 IgG index higher than that of patients treated with Fingolimod or anti-CD20 therapies [ 109 ]. Those patients who receive therapies that produce a reduction in B cells will present lower antibody titers and of short duration [ 108 ]. Thus, in the study by Bsteh et al (2021), observed seropositivity rates were equal to or greater than 80% in pwMS treated with Dimethyl fumarate (80%), Teriflunomide (83%), IFN-β (88.9%), Glatiramer acetate (88.9%), or Natalizumab (90.9%).…”

Section: Interaction Covid-19 and Multiple Sclerosismentioning

confidence: 99%

SARS-CoV-2 infection in multiple sclerosis patients: interaction with treatments, adjuvant therapies, and vaccines against COVID-19

et al. 2022

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The SARS-CoV-2 pandemic has raised particular concern for people with Multiple Sclerosis, as these people are believed to be at increased risk of infection, especially those being treated with disease-modifying therapies. Therefore, the objective of this review was to describe how COVID-19 affects people who suffer from Multiple Sclerosis, evaluating the risk they have of suffering an infection by this virus, according to the therapy to which they are subjected as well as the immune response of these patients both to infection and vaccines and the neurological consequences that the virus can have in the long term. The results regarding the increased risk of infection due to treatment are contradictory. B-cell depletion therapies may cause patients to have a lower probability of generating a detectable neutralizing antibody titer. However, more studies are needed to help understand how this virus works, paying special attention to long COVID and the neurological symptoms that it causes.

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Seroprevalence of SARS-CoV-2 in a Cohort of Patients with Multiple Sclerosis under Disease-Modifying Therapies

Cited by 3 publications

References 38 publications

Seroprevalence of SARS-CoV-2 in Patients with Multiple Sclerosis under Disease-Modifying Therapies: A Multi-Centre Study

Seroprevalence of SARS-CoV-2 in Patients with Multiple Sclerosis under Disease-Modifying Therapies: A Multi-Centre Study

A prospective study of cellular immune response to booster COVID-19 vaccination in multiple sclerosis patients treated with a broad spectrum of disease-modifying therapies

SARS-CoV-2 infection in multiple sclerosis patients: interaction with treatments, adjuvant therapies, and vaccines against COVID-19

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