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. 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

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

Koos P J van Dam et al. Front Neurol. .

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.

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Conflict of interest statement

FE reports consulting fees from UCB Pharma and CSl Behring; honoraria from Grifols. TR reports consulting fees from Novartis. Jki reported speaking and consulting relationships with Biogen, Genzyme, Merck, Novartis, Roche, Sanofi, and TEVA. Amsterdam UMC, location VUmc, MS Center Amsterdam has received financial support for research activities from Biogen, Celgene, Genzyme, Merck, Novartis, Roche, Sanofi, and TEVA. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Longitudinal SARS-CoV-2 antibody titers in patients with and without prior SARS-CoV-2 infection. The figure shows anti-RBD titers over time in patients with MS in various treatment groups. The x-axis shows time in days before and after the first vaccination. The y-axis is a logarithmic scale of anti-RBD-IgG titers in AU/mL. The Dots indicate antibody titers for individual participants. The black line indicates the regression line per group to demonstrate a trend. The horizontal black line indicates the cut-off for seroconversion (>4 AU/mL). The dotted lines, respectively, indicate the median timing of the first and second vaccination, either with mRNA vaccines (Moderna/Pfizer) or ChAdOx1 nCoV-19 (AZD1222) vaccine from Oxford-AstraZeneca. The median time between the first and second vaccination was 42 days.
See this image and copyright information in PMC

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