The presence of SARS-CoV2 antibodies in MS patients

Abstract

Background: The COVID-19 pandemic has raised novel concerns for people living with MS regarding their safety.

Methods: Observational study of patients at a single comprehensive community MS center.

Results: 48 patients with MS were suspected of developing COVID-19 March to May 2020; 2 died. Of the remainder, 17 were tested for COVID-19 antibodies as part of routine care. Average age of this subgroup was 49.8y ± 11.3 (age range 32-67), 76% female. 65% were treated with an anti-CD20 drug, 12% untreated, and 6% each received glatiramer acetate, interferon, natalizumab, or teriflunomide. 59% of patients were antibody negative.

Conclusions: The low incidence of SARS CoV2 antibodies following infection suggests that certain DMTs may alter SARS CoV2-Ab response or persistence.

Keywords: Anti-B cell treatment; COVID-19; COVID-19 antibodies; Disease modifying treatment; MS; Observational study.

Fig. 1

Patients presumed COVID-19 positive with subsequent SARS CoV2-Ab testing. Legend: • Each horizontal line indicates a single individual, numbered from 1 to 17, with their DMT at the time of infection listed. All but one patient were symptomatic. • Patients who required hospitalization have the word “Admitted” to the right of the bar chart all others were managed as outpatients. One patient was never clearly symptomatic and she is detected with “*asymptomatic” to the right of the bar chart. Antibody status is annotated on the far right for each patient. • In terms of infectious treatment Patients requiring admission for their severe COVID-19 related symptoms are annotated on the left. Patient #8, was treated with: azithromycin, zinc, hydroxychloroquine, high dose methylprednisolone and tocilizumab; Patient #9 required hydroxychloroquine, high dose methylprednisolone; Patient #11 admitted to an outside hospital for treatment of a blood clot due to non-adherence with anti-coagulation, treated with enoxaparin; Patient #16 was treated with hydroxychloroquine, zinc, azithromycin, high dose methylprednisolone and tocilizumab; Patient #17 was admitted to an outside hospital and reported treatment with intravenous steroids and antibiotics. None of the patients required intubation. • Patients who were treated for their viral symptoms without admission to the hospital- Patient #1, received two antibiotics, budesonide, oxygen and via nasal cannula and nebulizer treatment; Patient #2 was treated with azithromycin, acetaminophen, prednisone and a cough suppressant; Patient #3, 4, 6, 7, 12 and 15 -treatment unknown; Patient #5 steroids; Patient #10 and #13 received azithromycin, Patient #14 was never treated given asymptomatic.