With unclear characteristics of post-infection and post-vaccination immunity, the multiple sclerosis community lacks evidence to guide patients on their continued coronavirus disease 2019 (COVID-19) infection risk. As disease modifying treatments all modulate the immune system, we expect their use to alter acquired immunity to COVID-19, but the specific impact of individual treatments is unclear. To address this, we analyzed the patient and COVID-19 specific characteristics associated with post-infection humoral immunity in 58 patients with central nervous system (CNS) demyelinating disorders in the Boston metropolitan area. Univariate analysis of variance was performed using Mann Whitney U test for continuous variables, and Chi Square or Fisher Exact test for nominal variables. Univariate and stepwise multivariate nominal logistic regression identified clinical characteristics associated with COVID-19 specific nucleocapsid IgG antibody formation post-infection. Our cohort demonstrated a 42% post-infection seropositive rate with a significantly higher rate observed with shorter duration between infection and antibody collection and use of natalizumab over no/other treatment. Use of anti-CD20 treatments compared to no/other treatment was associated with a significantly lower rate of seropositivity. However, only shorter duration between infection and antibody collection as well as use of no/other treatment compared to anti-CD20 treatment were found to be independently associated with increased likelihood of post-infection seropositivity. Additionally, we demonstrate durability of antibody response up to 9 months in a small subset of patients. Thus, our data supports that patients with CNS demyelinating disorders regardless of DMT are able to form a measurable antibody response after COVID-19 infection, and that patients on anti-CD20 treatments form less robust immunity after COVID-19 infection.
【저자키워드】 multiple sclerosis, Disease modifying therapy, Natalizumab, COVID-19 antibody, anti-CD20 monoclonal antibodies, 【초록키워드】 COVID-19, Treatment, coronavirus disease, Immunity, Clinical characteristics, antibody, Antibody Response, Infection, immune system, Humoral immunity, Cohort, IgG antibody, Characteristics, COVID-19 infection, nucleocapsid, Patient, Community, Logistic regression, Central nervous system, infection risk, disease, CNS, patients, seropositive, Evidence, Support, Post-infection, analysis of variance, anti-CD20 treatment, Boston, significantly lower, Alter, likelihood, robust, square, analyzed, lack, the patient, was performed, less, modulate, demonstrated, significantly higher, subset, demyelinating disorder, Fisher Exact, variables, with COVID-19, 【제목키워드】 CNS, demyelinating,