Open AccessClinical features and outcomes of COVID-19 despite SARS-CoV-2 vaccination in people with multiple sclerosis
Author(s) -
Deja R Rose,
Ahmad Mahadeen,
Alise Carlson,
Sarah M. Planchon,
J Sedlák,
Scott Husak,
Robert A Bermel,
Jeffrey A. Cohen,
Brandon Moss
Publication year - 2021
Publication title -
multiple sclerosis journal, experimental, translational and clinical
Language(s) - English
Resource type - Journals
ISSN - 2055-2173
DOI - 10.1177/20552173211057110
Subject(s) - medicine , vaccination , fingolimod , multiple sclerosis , disease , covid-19 , pandemic , intensive care unit , intensive care medicine , pediatrics , immunology , infectious disease (medical specialty)
Background Several studies have demonstrated reduced serological response to vaccines in patients treated with anti-CD20 agents. However, limited data exist surrounding the clinical effect of disease modifying therapy (DMT) use on vaccine efficacy.Objectives To investigate breakthrough coronavirus disease 2019 (COVID-19) in vaccinated people with multiple sclerosis (PwMS) on DMT.Methods PwMS on DMT diagnosed with COVID-19 after full vaccination were identified from an existing Cleveland Clinic COVID-19 registry, supplemented by provider-identified cases. Demographics, disease history, DMTs, comorbidities, exposures, vaccination status, and COVID-19 outcomes were confirmed by review of the electronic medical record.Results Thirteen (3.8%) of 344 fully vaccinated people with multiple sclerosis on disease modifying therapy were diagnosed with COVID-19 after vaccination. Ten patients (76.9%) were on an anti-CD20 therapy, the remaining 3 (23.1%) on fingolimod. Only 2 patients (15.4%), both on anti-CD20 therapy, required hospitalization and steroid treatment. Neither required Intensive Care Unit admission.Conclusion Patients treated with anti-CD20 agents and sphingosine 1-phosphate receptor modulators may still be at risk for COVID-19 despite vaccination. While still at risk for hospitalization, intubation and death from COVID-19 appear rare. Larger studies analyzing how this may differ in the setting of emerging variants are needed.