SARS-COV2 exposure rates and serological response of people living with MS

• Introduction: Some multiple sclerosis (MS) disease-modifying therapies (DMTs) are  associated with blunted humoral vaccination responses, but relevance for SARS-CoV-2 infection is unclear.Objectives: To determine  SARS-CoV-2  exposure  rates  and  formation of antibody memory among participants of the COMparison Between   All   immunoTherapies   for   MS   (COMBAT-MS;   NCT03193866) and the Immunomodulation and MS Epidemiology (IMSE) studies.Aim: To determine SARS-CoV2 serological response of people living with MS (pwMS).Methods: Using  a  multiplex  bead-based  assay  we  determined  SARS-CoV-2  spike  and  nucleocapsid  antibody  levels  in  3,723  pwMS   in   paired   serum   samples   (n=7,157)   donated   prior   (Results: Specificity and sensitivity of the assay for SARS-CoV-2 was  100%  and  99.7%,  respectively.  The  proportion  of  positive  samples for SARS-CoV-2 differed moderately across DMTs with the highest values among cladribine-treated (7.4%) and the lowest number  among  rituximab-treated  pwMS  (3.9%). Similarly,  the  proportion of positive cases not reported in the Swedish MS registry varied from 100% for cladribine to 33.3% among untreated pwMS.  Comparing levels  of  antibodies  titers  showed  that  levels  were lower among those treated with rituximab or fingolimod vs interferon treated pwMS. Point estimates indicated a similar trend comparing rituximab or fingolimod vs untreated pwMS.Conclusions: Overall  rates  of  SARS-CoV-2  antibody  positivity  after  the  first COVID-19  wave  differed  only  moderately  across  DMTs,  while  antibody  levels were  lower  with  rituximab  or  fingolimod  compared  to  interferon-treated pwMS.  This  indicates  quantitative  rather  than  qualitative  differences  in  the humoral  response to infection.

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MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

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