COVID-19 infection after SARS-CoV-2 mRNA vaccination in Multiple Sclerosis, AQP4-antibody NMOSD and MOGAD patients during the Omicron subvariant BA.1/2 wave in Singapore.

Autor: Yeo T; Department of Neurology, National Neuroscience Institute, Singapore, Singapore. yeo.tianrong@singhealth.com.sg.; Duke-NUS Medical School, Singapore, Singapore. yeo.tianrong@singhealth.com.sg.; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. yeo.tianrong@singhealth.com.sg., Siew RWE; Department of Neurology, National Neuroscience Institute, Singapore, Singapore., Gulam MY; Department of Neurology, National Neuroscience Institute, Singapore, Singapore., Tye JSN; Department of Neurology, National Neuroscience Institute, Singapore, Singapore., Aw AYY; Department of Neurology, National Neuroscience Institute, Singapore, Singapore., Sivalingam T; Department of Neurology, National Neuroscience Institute, Singapore, Singapore., Peng X; Department of Neurology, National Neuroscience Institute, Singapore, Singapore., Yong KP; Department of Neurology, National Neuroscience Institute, Singapore, Singapore., Saffari SE; Department of Neurology, National Neuroscience Institute, Singapore, Singapore.; Duke-NUS Medical School, Singapore, Singapore., Chao Y; Department of Neurology, National Neuroscience Institute, Singapore, Singapore.; Duke-NUS Medical School, Singapore, Singapore.; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Tan K; Department of Neurology, National Neuroscience Institute, Singapore, Singapore.; Duke-NUS Medical School, Singapore, Singapore.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2023 Jun; Vol. 270 (6), pp. 2817-2825. Date of Electronic Publication: 2023 Apr 07.
DOI: 10.1007/s00415-023-11692-4
Abstrakt: Background: The SARS-CoV-2 Omicron variant appears to cause milder infections, however, its capacity for immune evasion and high transmissibility despite vaccination remains a concern, particularly in immunosuppressed patients. Herein, we investigate the incidence and risk factors for COVID-19 infection in vaccinated adult patients with Multiple Sclerosis (MS), Aquaporin-4-antibody Neuromyelitis Optica Spectrum Disorder (AQP4-Ab NMOSD), and Myelin Oligodendrocyte Glycoprotein-antibody associated disease (MOGAD) during the Omicron subvariant BA.1/2 wave in Singapore.
Methods: This was a prospective observational study conducted at the National Neuroscience Institute, Singapore. Only patients who had at least two doses of mRNA vaccines were included. Data on demographics, disease characteristics, COVID-19 infections and vaccinations, and immunotherapies were collected. SARS-CoV-2 neutralising antibodies were measured at various time points after vaccination.
Results: Two hundred and one patients were included; 47 had COVID-19 infection during the study period. Multivariable logistic regression revealed that receipt of a third SARS-CoV-2 mRNA vaccination (V3) was protective against COVID-19 infection. No particular immunotherapy group increased the risk of infection, however, Cox proportional-hazards regression showed that patients on anti-CD20s and sphingosine-1-phosphate modulators (S1PRMs) had a shorter time to infection after V3, compared to those on other immunotherapies or not on immunotherapy.
Conclusions: The Omicron subvariant BA.1/2 is highly infectious in patients with central nervous system inflammatory diseases; three doses of mRNA vaccination improved protection. However, treatment with anti-CD20s and S1PRMs predisposed patients to earlier infection. Future studies are required to determine the protective efficacy of newer bivalent vaccines that target the Omicron (sub)variant, especially in immunocompromised patients.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
Databáze: MEDLINE
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