Front Neurol . Longitudinal SARS-CoV-2 humoral response in MS patients with and without SARS-CoV-2 infection prior to vaccination

[tetano]

Front Neurol


. 2022 Nov 10;13:1032830.
doi: 10.3389/fneur.2022.1032830. eCollection 2022.
Longitudinal SARS-CoV-2 humoral response in MS patients with and without SARS-CoV-2 infection prior to vaccination


Koos P J van Dam ¹ , Laura Hogenboom ² , Eileen W Stalman ¹ , Laura Y L Kummer ³ , Maurice Steenhuis ^{3 4} , Jim B D Keijser ⁴ , Anja Ten Brinke ³ , S Marieke van Ham ^{3 5} , Taco W Kuijpers ⁶ , Theo Rispens ³ , Luuk Wieske ^{1 7} , Filip Eftimov ¹ , Eva M Strijbis ² , Joep Killestein ² , Zoé L E van Kempen ²



Affiliations

• PMID: 36438945
• PMCID: PMC9686308
• DOI: 10.3389/fneur.2022.1032830

Abstract

Introduction: During the COVID-19 pandemic, certain disease modifying therapies (DMTs) used in multiple sclerosis (MS), such as anti-CD20 therapies, have been associated with decreased humoral responses after SARS-CoV-2 vaccination. Hybrid immunity, referring to immunity after both vaccination and SARS-CoV-2 infection might increase humoral responses.
Methods: This was a substudy of two prospective cohort studies on SARS-CoV-2 antibodies after SARS-CoV-2 infection and vaccination. RBD-specific IgG titers of patients with MS and healthy controls who had experienced SARS-CoV-2 infection prior to the first vaccination were compared with those patients and healthy controls without prior infection. Humoral responses were measured at various time points after SARS-CoV-2 infection in convalescent patients and all patients prior to the first vaccination, 28 days after the first vaccination, and 28 days after the second vaccination.
Results: One hundred and two individuals [of which 34 patients with MS and DMTs (natalizumab or ocrelizumab), 30 patients without DMTs, and 38 healthy controls] were included. Fifty one of these individuals were convalescent. Median SARS-CoV-2 antibody titers were higher after the first vaccination in convalescent individuals compared with individuals without infection prior to vaccination. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody titers were comparable after the second vaccination in patients with MS with and without prior infection. However, in the convalescent ocrelizumab-treated patients, SARS-CoV-2 antibody titers did not increase after vaccinations.
Conclusion: In patients with MS without anti-CD20 therapies, SARS-CoV-2 infection before vaccination increases humoral responses after the first vaccination, similar to the healthy controls. In patients with MS treated with ocrelizumab (convalescent and non-convalescent), humoral responses remained low.

Keywords: COVID-19; SARS-CoV-2; disease modifying treatment; humoral response; multiple sclerosis.