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. 2021 Nov 26;7(4):20552173211057110.
doi: 10.1177/20552173211057110. eCollection 2021 Oct.

Clinical features and outcomes of COVID-19 despite SARS-CoV-2 vaccination in people with multiple sclerosis

Deja R Rose  1 , Ahmad Z Mahadeen  1 , Alise K Carlson  1 , Sarah M Planchon  1 , Jennifer Sedlak  1 , Scott Husak  1 , Robert A Bermel  1 , Jeffrey A Cohen  1 , Brandon P Moss  1
Affiliations

Clinical features and outcomes of COVID-19 despite SARS-CoV-2 vaccination in people with multiple sclerosis

Deja R Rose et al. Mult Scler J Exp Transl Clin. .

Abstract

Background: Several studies have demonstrated reduced serological response to vaccines in patients treated with anti-CD20 agents. However, limited data exist surrounding the clinical effect of disease modifying therapy (DMT) use on vaccine efficacy.

Objectives: To investigate breakthrough coronavirus disease 2019 (COVID-19) in vaccinated people with multiple sclerosis (PwMS) on DMT.

Methods: PwMS on DMT diagnosed with COVID-19 after full vaccination were identified from an existing Cleveland Clinic COVID-19 registry, supplemented by provider-identified cases. Demographics, disease history, DMTs, comorbidities, exposures, vaccination status, and COVID-19 outcomes were confirmed by review of the electronic medical record.

Results: Thirteen (3.8%) of 344 fully vaccinated people with multiple sclerosis on disease modifying therapy were diagnosed with COVID-19 after vaccination. Ten patients (76.9%) were on an anti-CD20 therapy, the remaining 3 (23.1%) on fingolimod. Only 2 patients (15.4%), both on anti-CD20 therapy, required hospitalization and steroid treatment. Neither required Intensive Care Unit admission.

Conclusion: Patients treated with anti-CD20 agents and sphingosine 1-phosphate receptor modulators may still be at risk for COVID-19 despite vaccination. While still at risk for hospitalization, intubation and death from COVID-19 appear rare. Larger studies analyzing how this may differ in the setting of emerging variants are needed.

Keywords: COVID-19; disease-modifying therapy; multiple sclerosis.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: R.A. Bermel has served as a consultant for Biogen, EMD Serono, Genzyme/Sanofi, Genentech/Roche, Novartis and Viela Bio.

References

    1. Yan ZP, Yang M, Lai CL. COVID-19 vaccines: A review of the safety and efficacy of current clinical trials. Pharmaceuticals 2021; 14: 406. doi:10.3390/PH14050406 - DOI - PMC - PubMed
    1. Moghadasi AN, Mirmosayyeb O, Barzegar M, Sahraian MA, Ghajarzadeh M. The prevalence of COVID-19 infection in patients with multiple sclerosis (MS): a systematic review and meta-analysis. Neurol Sci 2021; 1: 1. doi:10.1007/S10072-021-05373-1 - DOI - PMC - PubMed
    1. Möhn N, Konen FF, Pul R, et al. Experience in multiple sclerosis patients with COVID-19 and disease-modifying therapies: A review of 873 published cases. J Clin Med 2020; 9: 4067. doi:10.3390/JCM9124067 - DOI - PMC - PubMed
    1. Achiron A, Dolev M, Menascu S, et al. COVID-19 vaccination in patients with multiple sclerosis: What we have learnt by February 2021. Mult Scler J 2021; 27: 864–870. doi:10.1177/13524585211003476 - DOI - PMC - PubMed
    1. Friedli C, Diem L, Hammer H, et al. Negative SARS-CoV2-antibodies after positive COVID-19-PCR nasopharyngeal swab in patients treated with anti-CD20 therapies. Ther Adv Neurol Disord 2021; 14: 175628642110166. doi:10.1177/17562864211016641 - DOI - PMC - PubMed

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