Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study

Gabriel Bsteh; Sophie Dürauer; Hamid Assar; Harald Hegen; Bettina Heschl; Fritz Leutmezer; Franziska Di Pauli; Christiane Gradl; Gerhard Traxler; Gudrun Zulehner; Paulus Rommer; Peter Wipfler; Michael Guger; Romana Höftberger; Christian Enzinger; Thomas Berger

doi:10.1177/13524585211049391

Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study

Gabriel Bsteh^*, Sophie Dürauer, Hamid Assar, Harald Hegen, Bettina Heschl, Fritz Leutmezer, Franziska Di Pauli, Christiane Gradl, Gerhard Traxler, Gudrun Zulehner, Paulus Rommer, Peter Wipfler, Michael Guger, Romana Höftberger, Christian Enzinger, Thomas Berger

^*Corresponding author for this work

Division of Neurology (University Hospital St. Pölten)

Research output: Journal article (peer-reviewed) › Journal article

25 Citations (Scopus)

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.

Original language	English
Pages (from-to)	2209-2218
Number of pages	10
Journal	Multiple Sclerosis Journal
Volume	27
Issue number	14
DOIs	https://doi.org/10.1177/13524585211049391
Publication status	Published - Dec 2021

Keywords

Adult
Austria
COVID-19
Female
Humans
Immunity, Humoral
Male
Multiple Sclerosis/drug therapy
SARS-CoV-2

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10.1177/13524585211049391

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Bsteh, G., Dürauer, S., Assar, H., Hegen, H., Heschl, B., Leutmezer, F., Pauli, F. D., Gradl, C., Traxler, G., Zulehner, G., Rommer, P., Wipfler, P., Guger, M., Höftberger, R., Enzinger, C., & Berger, T. (2021). Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study. Multiple Sclerosis Journal, 27(14), 2209-2218. https://doi.org/10.1177/13524585211049391

@article{3e20a4c442254c25b6f52b2cb02aee0a,

title = "Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study",

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.",

keywords = "Adult, Austria, COVID-19, Female, Humans, Immunity, Humoral, Male, Multiple Sclerosis/drug therapy, SARS-CoV-2",

author = "Gabriel Bsteh and Sophie D{\"u}rauer and Hamid Assar and Harald Hegen and Bettina Heschl and Fritz Leutmezer and Pauli, {Franziska Di} and Christiane Gradl and Gerhard Traxler and Gudrun Zulehner and Paulus Rommer and Peter Wipfler and Michael Guger and Romana H{\"o}ftberger and Christian Enzinger and Thomas Berger",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2021.",

year = "2021",

month = dec,

doi = "10.1177/13524585211049391",

language = "English",

volume = "27",

pages = "2209--2218",

journal = "Multiple Sclerosis Journal",

issn = "1352-4585",

publisher = "SAGE Publications Ltd",

number = "14",

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Bsteh, G, Dürauer, S, Assar, H, Hegen, H, Heschl, B, Leutmezer, F, Pauli, FD, Gradl, C, Traxler, G, Zulehner, G, Rommer, P, Wipfler, P, Guger, M, Höftberger, R, Enzinger, C & Berger, T 2021, 'Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study', Multiple Sclerosis Journal, vol. 27, no. 14, pp. 2209-2218. https://doi.org/10.1177/13524585211049391

TY - JOUR

T1 - Humoral immune response after COVID-19 in multiple sclerosis

T2 - A nation-wide Austrian study

AU - Bsteh, Gabriel

AU - Dürauer, Sophie

AU - Assar, Hamid

AU - Hegen, Harald

AU - Heschl, Bettina

AU - Leutmezer, Fritz

AU - Pauli, Franziska Di

AU - Gradl, Christiane

AU - Traxler, Gerhard

AU - Zulehner, Gudrun

AU - Rommer, Paulus

AU - Wipfler, Peter

AU - Guger, Michael

AU - Höftberger, Romana

AU - Enzinger, Christian

AU - Berger, Thomas

PY - 2021/12

Y1 - 2021/12

N2 - 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.

AB - 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.

KW - Adult

KW - Austria

KW - COVID-19

KW - Female

KW - Humans

KW - Immunity, Humoral

KW - Male

KW - Multiple Sclerosis/drug therapy

KW - SARS-CoV-2

UR - http://www.scopus.com/inward/record.url?scp=85116394503&partnerID=8YFLogxK

U2 - 10.1177/13524585211049391

DO - 10.1177/13524585211049391

M3 - Journal article

C2 - 34595968

SN - 1352-4585

VL - 27

SP - 2209

EP - 2218

JO - Multiple Sclerosis Journal

JF - Multiple Sclerosis Journal

IS - 14

ER -

Humoral immune response after COVID-19 in multiple sclerosis: A nation-wide Austrian study

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