COVID-19 vaccine response in Neuromyelitis Optica Spectrum Disorder

Area of Science:

• Immunology
• Neurology
• Infectious Diseases

Background:

• Neuromyelitis Optica Spectrum Disorder (NMOSD) is an autoimmune CNS disease requiring immunosuppressants, increasing COVID-19 severity risk.
• Vaccine efficacy in immunocompromised NMOSD patients is largely unknown.
• Evaluating antibody response post-vaccination is crucial for managing pandemic risks in this population.

Purpose of the Study:

• To assess and compare antibody levels in NMOSD patients on disease-modifying therapies after two doses of inactivated and mRNA COVID-19 vaccines.
• To compare vaccine response between NMOSD patients and healthy controls.
• To identify potential differences in vaccine efficacy based on specific NMOSD treatments.

Main Methods:

• Recruited NMOSD patients and age-sex matched healthy controls who received two doses of inactivated or mRNA COVID-19 vaccines.
• Collected serum samples at least two weeks post-second vaccine dose.
• Evaluated serum antibody titers in both groups.

Main Results:

• Mean antibody titer was significantly lower in NMOSD patients (2.43 ± 1.51) compared to healthy controls (3.23 ± 0.80).
• Seronegativity was observed exclusively in NMOSD patients treated with rituximab (9 cases), with no seronegative cases in the azathioprine group.
• NMOSD patient cohort: 24 individuals (Mean age 36.58, 70.83% female). Healthy control cohort: 24 individuals (Mean age 36.71, 70.83% female).

Conclusions:

• NMOSD patients, particularly those on rituximab, may exhibit reduced protection against severe COVID-19 infection post-vaccination.
• Lower antibody titers in NMOSD patients suggest a potential need for enhanced preventive strategies.
• Further research is warranted to optimize vaccination protocols for immunocompromised individuals with NMOSD.