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Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study
Background: Knowledge on immunity after SARS-CoV-2 infection in patients with multiple sclerosis (pwMS) and the impact of disease-modifying treatment (DMT) is limited. Objective: To evaluate degree, duration and potential predictors of specific humoral immune response in pwMS with prior COVID-19. Me...
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| Published in: | Multiple sclerosis 2021-12, Vol.27 (14), p.2209-2218 |
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| Main Authors: | , , , , , , , , , , , , , , , |
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| container_end_page | 2218 |
| container_issue | 14 |
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| container_title | Multiple sclerosis |
| container_volume | 27 |
| creator | Bsteh, Gabriel Dürauer, Sophie Assar, Hamid Hegen, Harald Heschl, Bettina Leutmezer, Fritz Pauli, Franziska Di Gradl, Christiane Traxler, Gerhard Zulehner, Gudrun Rommer, Paulus Wipfler, Peter Guger, Michael Höftberger, Romana Enzinger, Christian Berger, Thomas |
| description | Background:
Knowledge on immunity after SARS-CoV-2 infection in patients with multiple sclerosis (pwMS) and the impact of disease-modifying treatment (DMT) is limited.
Objective:
To evaluate degree, duration and potential predictors of specific humoral immune response in pwMS with prior COVID-19.
Methods:
Anti-SARS-CoV-2 antibody testing was performed in pwMS with PCR-confirmed diagnosis of symptomatic COVID-19 from a nation-wide registry. Predictors of seropositivity were identified by multivariate regression models.
Results:
In 125 pwMS (mean age = 42.4 years (SD = 12.3 years), 70% female), anti-SARS-CoV-2 antibodies were detected in 76.0% after a median of 5.2 months from positive PCR. Seropositivity rate was significantly lower in patients on IS-DMT (61.4%, p = 0.001) than without DMT or immunomodulatory DMT (80.6%; 86.0%, respectively). In multivariate analysis, IS-DMT was associated with reduced probability of seropositivity (odds ratio (OR): 0.51; 95% confidence interval (95% CI): 0.17–0.82; p |
| doi_str_mv | 10.1177/13524585211049391 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8597187</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_13524585211049391</sage_id><sourcerecordid>2578774281</sourcerecordid><originalsourceid>FETCH-LOGICAL-c443t-893a2a1bd8e77bcab295e705d31487eb3f513e771578a8a5fc56e458cf034cf03</originalsourceid><addsrcrecordid>eNp1kU1vFSEYhUmjsV_-gO5I3LiZlneAAi5Mbq72I2nSjXbhhjAz71SaGbjCoOm_l5vb2FjjBkjOcw4cXkJOgJ0CKHUGXLZCatkCMGG4gT1yAEKphhnFXtVz1ZstsE8Oc35gjCnF5Ruyz4U00pzrA_LtqswxuYn6eS4BacK8iSEjdeOCia5v764_NWCoD3Qu0-I3E9LcT5hi9vkDXdHgFh9D88sPSFclL8m7QPNShsdj8np0U8a3T_sR-Xrx-cv6qrm5vbxer26aXgi-NNpw1zroBo1Kdb3rWiNRMTlwEFphx0cJvEoglXbaybGX51hL9SPjYrsckY-73E3pZhx6DEstZDfJzy492ui8_VsJ_ru9jz-tlkaBVjXg_VNAij8K5sXOPvc4TS5gLNm29WalRKuhou9eoA-xpFDrVcpoxluQolKwo_r6TTnh-OcxwOx2cvafyVXP6c6T3T0-p_7f8BtlK5bC</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2598032154</pqid></control><display><type>article</type><title>Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study</title><source>Sage Journals Online</source><creator>Bsteh, Gabriel ; Dürauer, Sophie ; Assar, Hamid ; Hegen, Harald ; Heschl, Bettina ; Leutmezer, Fritz ; Pauli, Franziska Di ; Gradl, Christiane ; Traxler, Gerhard ; Zulehner, Gudrun ; Rommer, Paulus ; Wipfler, Peter ; Guger, Michael ; Höftberger, Romana ; Enzinger, Christian ; Berger, Thomas</creator><creatorcontrib>Bsteh, Gabriel ; Dürauer, Sophie ; Assar, Hamid ; Hegen, Harald ; Heschl, Bettina ; Leutmezer, Fritz ; Pauli, Franziska Di ; Gradl, Christiane ; Traxler, Gerhard ; Zulehner, Gudrun ; Rommer, Paulus ; Wipfler, Peter ; Guger, Michael ; Höftberger, Romana ; Enzinger, Christian ; Berger, Thomas</creatorcontrib><description>Background:
Knowledge on immunity after SARS-CoV-2 infection in patients with multiple sclerosis (pwMS) and the impact of disease-modifying treatment (DMT) is limited.
Objective:
To evaluate degree, duration and potential predictors of specific humoral immune response in pwMS with prior COVID-19.
Methods:
Anti-SARS-CoV-2 antibody testing was performed in pwMS with PCR-confirmed diagnosis of symptomatic COVID-19 from a nation-wide registry. Predictors of seropositivity were identified by multivariate regression models.
Results:
In 125 pwMS (mean age = 42.4 years (SD = 12.3 years), 70% female), anti-SARS-CoV-2 antibodies were detected in 76.0% after a median of 5.2 months from positive PCR. Seropositivity rate was significantly lower in patients on IS-DMT (61.4%, p = 0.001) than without DMT or immunomodulatory DMT (80.6%; 86.0%, respectively). In multivariate analysis, IS-DMT was associated with reduced probability of seropositivity (odds ratio (OR): 0.51; 95% confidence interval (95% CI): 0.17–0.82; p < 0.001). Predefined subgroup analyses showed marked reduction of seropositivity in pwMS on rituximab/ocrelizumab (OR 0.15; 95% CI: 0.05–0.56; p < 0.001). Rate of seropositivity did not change significantly over 6 months.
Conclusions:
Humoral immunity is stable after SARS-CoV-2 infection in MS, but is reduced by immunosuppressive DMT, particularly anti-CD20 monoclonal antibodies. This provides important evidence for advising pwMS as well as for planning and prioritizing vaccination.</description><identifier>ISSN: 1352-4585</identifier><identifier>EISSN: 1477-0970</identifier><identifier>DOI: 10.1177/13524585211049391</identifier><identifier>PMID: 34595968</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>CD20 antigen ; Coronaviruses ; COVID-19 ; Humoral immunity ; Immune response (humoral) ; Immunomodulation ; Monoclonal antibodies ; Multiple sclerosis ; Multivariate analysis ; Original Research Papers ; Patients ; Regression analysis ; Rituximab ; Severe acute respiratory syndrome coronavirus 2 ; Vaccination</subject><ispartof>Multiple sclerosis, 2021-12, Vol.27 (14), p.2209-2218</ispartof><rights>The Author(s), 2021</rights><rights>The Author(s), 2021 2021 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-893a2a1bd8e77bcab295e705d31487eb3f513e771578a8a5fc56e458cf034cf03</citedby><cites>FETCH-LOGICAL-c443t-893a2a1bd8e77bcab295e705d31487eb3f513e771578a8a5fc56e458cf034cf03</cites><orcidid>0000-0001-8219-781X ; 0000-0002-0825-0851 ; 0000-0001-5209-6647 ; 0000-0001-5626-1144</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925,79364</link.rule.ids></links><search><creatorcontrib>Bsteh, Gabriel</creatorcontrib><creatorcontrib>Dürauer, Sophie</creatorcontrib><creatorcontrib>Assar, Hamid</creatorcontrib><creatorcontrib>Hegen, Harald</creatorcontrib><creatorcontrib>Heschl, Bettina</creatorcontrib><creatorcontrib>Leutmezer, Fritz</creatorcontrib><creatorcontrib>Pauli, Franziska Di</creatorcontrib><creatorcontrib>Gradl, Christiane</creatorcontrib><creatorcontrib>Traxler, Gerhard</creatorcontrib><creatorcontrib>Zulehner, Gudrun</creatorcontrib><creatorcontrib>Rommer, Paulus</creatorcontrib><creatorcontrib>Wipfler, Peter</creatorcontrib><creatorcontrib>Guger, Michael</creatorcontrib><creatorcontrib>Höftberger, Romana</creatorcontrib><creatorcontrib>Enzinger, Christian</creatorcontrib><creatorcontrib>Berger, Thomas</creatorcontrib><title>Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study</title><title>Multiple sclerosis</title><addtitle>Mult Scler</addtitle><description>Background:
Knowledge on immunity after SARS-CoV-2 infection in patients with multiple sclerosis (pwMS) and the impact of disease-modifying treatment (DMT) is limited.
Objective:
To evaluate degree, duration and potential predictors of specific humoral immune response in pwMS with prior COVID-19.
Methods:
Anti-SARS-CoV-2 antibody testing was performed in pwMS with PCR-confirmed diagnosis of symptomatic COVID-19 from a nation-wide registry. Predictors of seropositivity were identified by multivariate regression models.
Results:
In 125 pwMS (mean age = 42.4 years (SD = 12.3 years), 70% female), anti-SARS-CoV-2 antibodies were detected in 76.0% after a median of 5.2 months from positive PCR. Seropositivity rate was significantly lower in patients on IS-DMT (61.4%, p = 0.001) than without DMT or immunomodulatory DMT (80.6%; 86.0%, respectively). In multivariate analysis, IS-DMT was associated with reduced probability of seropositivity (odds ratio (OR): 0.51; 95% confidence interval (95% CI): 0.17–0.82; p < 0.001). Predefined subgroup analyses showed marked reduction of seropositivity in pwMS on rituximab/ocrelizumab (OR 0.15; 95% CI: 0.05–0.56; p < 0.001). Rate of seropositivity did not change significantly over 6 months.
Conclusions:
Humoral immunity is stable after SARS-CoV-2 infection in MS, but is reduced by immunosuppressive DMT, particularly anti-CD20 monoclonal antibodies. This provides important evidence for advising pwMS as well as for planning and prioritizing vaccination.</description><subject>CD20 antigen</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Humoral immunity</subject><subject>Immune response (humoral)</subject><subject>Immunomodulation</subject><subject>Monoclonal antibodies</subject><subject>Multiple sclerosis</subject><subject>Multivariate analysis</subject><subject>Original Research Papers</subject><subject>Patients</subject><subject>Regression analysis</subject><subject>Rituximab</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Vaccination</subject><issn>1352-4585</issn><issn>1477-0970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><recordid>eNp1kU1vFSEYhUmjsV_-gO5I3LiZlneAAi5Mbq72I2nSjXbhhjAz71SaGbjCoOm_l5vb2FjjBkjOcw4cXkJOgJ0CKHUGXLZCatkCMGG4gT1yAEKphhnFXtVz1ZstsE8Oc35gjCnF5Ruyz4U00pzrA_LtqswxuYn6eS4BacK8iSEjdeOCia5v764_NWCoD3Qu0-I3E9LcT5hi9vkDXdHgFh9D88sPSFclL8m7QPNShsdj8np0U8a3T_sR-Xrx-cv6qrm5vbxer26aXgi-NNpw1zroBo1Kdb3rWiNRMTlwEFphx0cJvEoglXbaybGX51hL9SPjYrsckY-73E3pZhx6DEstZDfJzy492ui8_VsJ_ru9jz-tlkaBVjXg_VNAij8K5sXOPvc4TS5gLNm29WalRKuhou9eoA-xpFDrVcpoxluQolKwo_r6TTnh-OcxwOx2cvafyVXP6c6T3T0-p_7f8BtlK5bC</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Bsteh, Gabriel</creator><creator>Dürauer, Sophie</creator><creator>Assar, Hamid</creator><creator>Hegen, Harald</creator><creator>Heschl, Bettina</creator><creator>Leutmezer, Fritz</creator><creator>Pauli, Franziska Di</creator><creator>Gradl, Christiane</creator><creator>Traxler, Gerhard</creator><creator>Zulehner, Gudrun</creator><creator>Rommer, Paulus</creator><creator>Wipfler, Peter</creator><creator>Guger, Michael</creator><creator>Höftberger, Romana</creator><creator>Enzinger, Christian</creator><creator>Berger, Thomas</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8219-781X</orcidid><orcidid>https://orcid.org/0000-0002-0825-0851</orcidid><orcidid>https://orcid.org/0000-0001-5209-6647</orcidid><orcidid>https://orcid.org/0000-0001-5626-1144</orcidid></search><sort><creationdate>20211201</creationdate><title>Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study</title><author>Bsteh, Gabriel ; Dürauer, Sophie ; Assar, Hamid ; Hegen, Harald ; Heschl, Bettina ; Leutmezer, Fritz ; Pauli, Franziska Di ; Gradl, Christiane ; Traxler, Gerhard ; Zulehner, Gudrun ; Rommer, Paulus ; Wipfler, Peter ; Guger, Michael ; Höftberger, Romana ; Enzinger, Christian ; Berger, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-893a2a1bd8e77bcab295e705d31487eb3f513e771578a8a5fc56e458cf034cf03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>CD20 antigen</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Humoral immunity</topic><topic>Immune response (humoral)</topic><topic>Immunomodulation</topic><topic>Monoclonal antibodies</topic><topic>Multiple sclerosis</topic><topic>Multivariate analysis</topic><topic>Original Research Papers</topic><topic>Patients</topic><topic>Regression analysis</topic><topic>Rituximab</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Vaccination</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bsteh, Gabriel</creatorcontrib><creatorcontrib>Dürauer, Sophie</creatorcontrib><creatorcontrib>Assar, Hamid</creatorcontrib><creatorcontrib>Hegen, Harald</creatorcontrib><creatorcontrib>Heschl, Bettina</creatorcontrib><creatorcontrib>Leutmezer, Fritz</creatorcontrib><creatorcontrib>Pauli, Franziska Di</creatorcontrib><creatorcontrib>Gradl, Christiane</creatorcontrib><creatorcontrib>Traxler, Gerhard</creatorcontrib><creatorcontrib>Zulehner, Gudrun</creatorcontrib><creatorcontrib>Rommer, Paulus</creatorcontrib><creatorcontrib>Wipfler, Peter</creatorcontrib><creatorcontrib>Guger, Michael</creatorcontrib><creatorcontrib>Höftberger, Romana</creatorcontrib><creatorcontrib>Enzinger, Christian</creatorcontrib><creatorcontrib>Berger, Thomas</creatorcontrib><collection>SAGE Open Access Journals</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Multiple sclerosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bsteh, Gabriel</au><au>Dürauer, Sophie</au><au>Assar, Hamid</au><au>Hegen, Harald</au><au>Heschl, Bettina</au><au>Leutmezer, Fritz</au><au>Pauli, Franziska Di</au><au>Gradl, Christiane</au><au>Traxler, Gerhard</au><au>Zulehner, Gudrun</au><au>Rommer, Paulus</au><au>Wipfler, Peter</au><au>Guger, Michael</au><au>Höftberger, Romana</au><au>Enzinger, Christian</au><au>Berger, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study</atitle><jtitle>Multiple sclerosis</jtitle><addtitle>Mult Scler</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>27</volume><issue>14</issue><spage>2209</spage><epage>2218</epage><pages>2209-2218</pages><issn>1352-4585</issn><eissn>1477-0970</eissn><abstract>Background:
Knowledge on immunity after SARS-CoV-2 infection in patients with multiple sclerosis (pwMS) and the impact of disease-modifying treatment (DMT) is limited.
Objective:
To evaluate degree, duration and potential predictors of specific humoral immune response in pwMS with prior COVID-19.
Methods:
Anti-SARS-CoV-2 antibody testing was performed in pwMS with PCR-confirmed diagnosis of symptomatic COVID-19 from a nation-wide registry. Predictors of seropositivity were identified by multivariate regression models.
Results:
In 125 pwMS (mean age = 42.4 years (SD = 12.3 years), 70% female), anti-SARS-CoV-2 antibodies were detected in 76.0% after a median of 5.2 months from positive PCR. Seropositivity rate was significantly lower in patients on IS-DMT (61.4%, p = 0.001) than without DMT or immunomodulatory DMT (80.6%; 86.0%, respectively). In multivariate analysis, IS-DMT was associated with reduced probability of seropositivity (odds ratio (OR): 0.51; 95% confidence interval (95% CI): 0.17–0.82; p < 0.001). Predefined subgroup analyses showed marked reduction of seropositivity in pwMS on rituximab/ocrelizumab (OR 0.15; 95% CI: 0.05–0.56; p < 0.001). Rate of seropositivity did not change significantly over 6 months.
Conclusions:
Humoral immunity is stable after SARS-CoV-2 infection in MS, but is reduced by immunosuppressive DMT, particularly anti-CD20 monoclonal antibodies. This provides important evidence for advising pwMS as well as for planning and prioritizing vaccination.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>34595968</pmid><doi>10.1177/13524585211049391</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8219-781X</orcidid><orcidid>https://orcid.org/0000-0002-0825-0851</orcidid><orcidid>https://orcid.org/0000-0001-5209-6647</orcidid><orcidid>https://orcid.org/0000-0001-5626-1144</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Multiple sclerosis, 2021-12, Vol.27 (14), p.2209-2218 |
| issn | 1352-4585 1477-0970 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8597187 |
| source | Sage Journals Online |
| subjects | CD20 antigen Coronaviruses COVID-19 Humoral immunity Immune response (humoral) Immunomodulation Monoclonal antibodies Multiple sclerosis Multivariate analysis Original Research Papers Patients Regression analysis Rituximab Severe acute respiratory syndrome coronavirus 2 Vaccination |
| title | Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study |
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