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Immune responses following COVID-19 infection in multiple sclerosis patients using immunomodulatory therapy
Nuray Bilge1, Fatma Kesmez Can2, Recep Yevgi3
1Faculty of Medicine, Department of Neurology, Atatürk University, Erzurum, Turkey.
Abstract:
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2), has quickly become a global pandemic. Most multiple sclerosis (MS) patients use disease-modifying treatments (DMTs), such as immunomodulators or immunosuppressants. By targeting different types of immune cells, DMTs affect cellular and/or humoral immunity. The potential effects of DMTs on the long-term immune response to COVID-19 is not fully known. Between 16.04.2020 and 15.07.2020, a total of 34 people, 17 of whom were diagnosed with MS according to the 2010 McDonald diagnostic criteria and a control group of 17 individuals who did not have a known systemic disease who were matched according to age, gender, and COVID-19 disease severity, where all received COVID-19 diagnosis with SARS-CoV-2 PCR positivity in nasopharyngeal swab test and immune responses were measured (SARS-CoV-2 IgM and IgG antibody levels COVID 19 ELISA kit), were included in our study. Demographic data of MS patients and the control group, SARS-CoV-2 immune responses, antibody titers and disease year of MS patients, EDSS scores, disease type, and disease duration were determined. All patients were symptomatic for COVID-19. COVID-19 disease severity was divided into three groups as mild, moderate, and severe according to the clinical condition of the patient. Demographic data of MS patients and the control group, SARS-CoV-2 immune responses, antibody titers and disease year of MS patients, EDSS scores, disease type, and disease duration were determined. All patients were symptomatic for COVID-19. COVID-19 disease severity was divided into three groups as mild, moderate, and severe according to the clinical condition of the patient. According to our study results, IgG-type long-term immune responses were lower in MS patients using DMTs than in the healthy population. We hope that our study will provide insight into the COVID-19 vaccine immune responses.
Insights
Multiple sclerosis patients on disease-modifying therapies show reduced long-term IgG antibody responses to COVID-19 compared to healthy individuals. This finding may impact COVID-19 vaccine efficacy in this population.
Area of Science:
- Immunology
- Neurology
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) is a global pandemic caused by SARS-CoV-2.
- Multiple Sclerosis (MS) patients often use disease-modifying treatments (DMTs) that impact immune function.
- The long-term immune response to COVID-19 in MS patients using DMTs is not well understood.
Purpose of the Study:
- To investigate and compare the long-term immune responses to COVID-19 in MS patients undergoing DMTs versus a healthy control group.
- To assess the impact of DMTs on SARS-CoV-2 antibody titers and overall immune response.
Main Methods:
- A study cohort included 17 MS patients (diagnosed via 2010 McDonald criteria) and 17 matched healthy controls, all symptomatic with COVID-19 confirmed by PCR.
- Immune responses were measured using SARS-CoV-2 IgM and IgG antibody levels via ELISA kits.
- Demographic data, disease characteristics (EDSS, type, duration), and COVID-19 severity were recorded for all participants.
Main Results:
- MS patients utilizing DMTs exhibited significantly lower IgG antibody titers, indicating a weaker long-term immune response to COVID-19 compared to the healthy control group.
- All participants were symptomatic, with disease severity categorized as mild, moderate, or severe.
Conclusions:
- Disease-modifying treatments in multiple sclerosis patients may attenuate the long-term antibody-mediated immune response to SARS-CoV-2 infection.
- Findings suggest potential implications for the efficacy of COVID-19 vaccines in MS patients on DMTs, warranting further investigation.
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