Blunted Post-COVID-19 Humoral Immunity in Patients With CNS Demyelinating Disorders on Anti-CD20 Treatments
Blunted Post-COVID-19 Humoral Immunity in Patients With CNS Demyelinating Disorders on Anti-CD20 Treatments
Blog Article
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 body surf board 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 Door Hinges 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 copyright 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.