scholarly journals Approach to SARS-CoV-2 Vaccination in Patients With Multiple Sclerosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Christina Woopen ◽  
Katharina Schleußner ◽  
Katja Akgün ◽  
Tjalf Ziemssen
Keyword(s):  
Multiple Sclerosis ◽  
Immune Response ◽  
Severe Acute Respiratory Syndrome ◽  
Cellular Immunity ◽  
Cellular Responses ◽  
Immunosuppressive Drugs ◽  
Clinical Use ◽  
Immunocompromised Patients ◽  
Vaccine Response ◽  
Safety And Efficacy

For more than a year now, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been causing the coronavirus disease (COVID-19) pandemic with high mortality and detrimental effects on society, economy, and individual lives. Great hopes are being placed on vaccination as one of the most potent escape strategies from the pandemic and multiple vaccines are already in clinical use. However, there is still a lot of insecurity about the safety and efficacy of vaccines in patients with autoimmune diseases like multiple sclerosis (MS), especially under treatment with immunomodulatory or immunosuppressive drugs. We propose strategic approaches to SARS-CoV-2 vaccination management in MS patients and encourage fellow physicians to measure the immune response in their patients. Notably, both humoral and cellular responses should be considered since the immunological equivalent for protection from SARS-CoV-2 after infection or vaccination still remains undefined and will most likely involve antiviral cellular immunity. It is important to gain insights into the vaccine response of immunocompromised patients in order to be able to deduce sensible strategies for vaccination in the future.

scholarly journals Humoral and cellular responses after a third dose of BNT162b2 vaccine in patients treated for lymphoid malignancies.

2021 ◽  
Author(s):  
Daniel Re ◽  
barbara Seitz-Polski ◽  
Michel Carles ◽  
Vesna Brglez ◽  
Daisy Graca ◽  
...  
Keyword(s):  
Immune Response ◽  
T Cell ◽  
Cellular Response ◽  
Vaccine Dose ◽  
Cellular Responses ◽  
Double Negative ◽  
Immunocompromised Patients ◽  
Ifn Gamma ◽  
Lymphoid Malignancies ◽  
Anti Cd20

Humoral and cellular responses after a third dose of BNT162b2 vaccine in patients treated for lymphoid malignancies. BACKGROUND: Immunocompromised patients such as patients with hematological malignancies have impaired immune response to two doses of BNT162b2 (Pfizer / BioNtech) vaccine against SARS-CoV-2. Evaluation of a repeated immune stimulation with a third vaccine dose is needed. METHODS: a vaccine monitoring observatory was conducted in outpatients who were treated for lymphoid malignancies (LM) to monitor both immune and cellular response measured the day of administration of the dose 3 of the mRNA vaccine BNT162b2 and again three to four weeks. Elecsys Anti-SARS-CoV-2 immunoassay was used to asses to the level of SARS-CoV-2 anti-Spike (S) antibodies (Abs) titer and SARS-CoV-2-specific T-cell responses were assessed by a whole blood Interferon-Gamma Release Immuno Assay (IGRA) (QuantiFERON Human IFN-gamma SARS-CoV-2, Qiagen). RESULTS: Among the 43 assessable patients (suffering from chronic lymphocytic leukemia (CLL) (n=15), indolent and aggressive B cell non-Hodgkin lymphoma (NHL) (n=14), and multiple myeloma (MM) (n=16)), 18 (41,8%) had no anti-S Abs before the dose 3 of BNT162b2 vaccine (n=9 CLL, n=8 NHL, n=1 MM), and they all 18 remained negative after the dose 3. Amongst the 25 patients with positive anti-S titers before dose 3, all patients remained positive and 23 patients increased their anti-S titer after dose 3. Patients with CLL and/or with previous anti-CD20 therapy treated within 12 months of administration of dose 3 had no significant increase of the humoral response. Among 22 available patients, dose 3 of BNT162b2 vaccine significantly increased the median IFN-gamma secretion. On eight (36.4%) patients who were double-negative for both immune and cellular response, five (22.7%) patients remained double-negative after dose 3. CONCLUSIONS Dose 3 of BNT162b2 vaccine stimulated humoral immune response among patients with LM, in particular patients with MM (who had higher anti-S baseline titer after dose 2) and those with no anti-CD20 treatment history within a year. T-cell response was increased among patients in particular with no active chemotherapy regimen. Our data support the use of an early third vaccine dose among immunocompromised patients followed for LM though some of them will still have vaccine failure.

scholarly journals Disease-modifying therapies and SARS-CoV-2 vaccination in multiple sclerosis: an expert consensus

2021 ◽  
Author(s):  
Diego Centonze ◽  
Maria A. Rocca ◽  
Claudio Gasperini ◽  
Ludwig Kappos ◽  
Hans-Peter Hartung ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Severe Acute Respiratory Syndrome ◽  
Vaccination Campaign ◽  
Safety And Efficacy ◽  
Chinese City ◽  
Disease Modifying Therapies ◽  
Global Pandemic ◽  
The World ◽  
Disease Modifying

AbstractCoronavirus disease (COVID-19) appeared in December 2019 in the Chinese city of Wuhan and has quickly become a global pandemic. The disease is caused by the severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2), an RNA beta coronavirus phylogenetically similar to SARS coronavirus. To date, more than 132 million cases of COVID19 have been recorded in the world, of which over 2.8 million were fatal (https://coronavirus.jhu.edu/map.html). A huge vaccination campaign has started around the world since the end of 2020. The availability of vaccines has raised some concerns among neurologists regarding the safety and efficacy of vaccination in patients with multiple sclerosis (MS) taking immunomodulatory or immunosuppressive therapies.

scholarly journals Humoral and cellular responses to SARS-CoV-2 vaccination in patients with lymphoid malignancies

2021 ◽  
Author(s):  
Sean H. Lim ◽  
Nicola Campbell ◽  
Beth Stuart ◽  
Marina Johnson ◽  
Debora Joseph-Pietras ◽  
...  
Keyword(s):  
Immune Response ◽  
T Cell ◽  
T Cell Responses ◽  
B Cell Lymphoma ◽  
Cellular Responses ◽  
Response Monitoring ◽  
Vaccine Response ◽  
Humoral And Cellular Immunity ◽  
Cell Responses ◽  
Anti Cd20

SUMMARYSARS-CoV-2 vaccination protects against COVID-19. Antibodies and antigen-specific T-cell responses against the spike domain can be used to measure vaccine immune response. Individuals with lymphoma have defects in humoral and cellular immunity that may compromise vaccine response. In this prospective observational study of 457 participants with lymphoma, 52% of participants vaccinated on treatment had undetectable anti-spike IgG antibodies compared to 9% who were not on treatment. Marked impairment was observed in those receiving anti- CD20 antibody within 12 months where 60% had undetectable antibodies compared to 11% on chemotherapy, which persisted despite three vaccine doses. Overall, 63% had positive T-cell responses irrespective of treatment. Individuals with indolent B-cell lymphoma have impaired antibody and cellular responses that were independent of treatment. The significant reduction and heterogeneity in immune responses in these individuals emphasise the urgent need for immune response monitoring and alternative prophylactic strategies to protect against COVID- 19.

scholarly journals A Comparison of the Clinical, Viral, Pathologic, and Immunologic Features of Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and Coronavirus 2019 (COVID-19) Diseases

2021 ◽  
Author(s):  
Rolf F. Barth ◽  
L. Maximillian Buja ◽  
Alison L. Barth ◽  
David E. Carpenter ◽  
Anil V. Parwani
Keyword(s):  
Immune Response ◽  
Middle East ◽  
Severe Acute Respiratory Syndrome ◽  
Diffuse Alveolar Damage ◽  
Middle East Respiratory Syndrome ◽  
Host Immune System ◽  
Clinical Use ◽  
Clinical Considerations ◽  
Time Of Presentation ◽  
Cellular Components

Context.—The purpose of this review is to compare three coronavirus diseases: severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19) caused by SARS-CoV, MERS-CoV, and SARS-CoV-2 viruses, respectively. Objective.—To cover the following topics: clinical considerations, viral characteristics, pathology, immune response, pathogenesis, and the prognosis associated with each coronavirus human disease in humans. Data Sources.—Clinically, flu-like symptoms are usual at the time of presentation for all 3 diseases, but these vary from asymptomatic to severe multi-system involvement. The pathology associated with symptomatic SARS and COVID-19 has been well described, the most prominent of which is diffuse alveolar damage (DAD). The immune response to each of these viruses is highly complex and includes both humoral and cellular components that can have a significant impact on prognosis. In severe cases of COVID-19, a dysregulated innate host immune system can initiate a hyperinflammatory syndrome dominated by endothelial dysfunction that can lead to a hypercoagulable state with microthrombi, resulting in a systemic micro- and macro-vascular disease. Conclusions.—The SARS and MERS epidemics have been limited, involving 7,500 and 2,500 individuals, respectively. In contrast, COVID-19 has resulted in a worldwide pandemic with over 177 million cases and 3.9 million deaths as of June 15, 2021, and fatality rates ranging from <0.1% to ~10% depending upon the country. Ending on a positive note, the development of a number of vaccines, at least six of which now are in clinical use, should mitigate and eventually control the devastating COVID-19 pandemic.

scholarly journals COVID-19 Vaccine Failure in a Patient with Multiple Sclerosis on Ocrelizumab

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 219
Author(s):  
Sridhar Chilimuri ◽  
Nikhitha Mantri ◽  
Sudharsan Gongati ◽  
Maleeha Zahid ◽  
Haozhe Sun
Keyword(s):  
Multiple Sclerosis ◽  
B Cell ◽  
Vaccine Efficacy ◽  
Limited Data ◽  
Vaccine Response ◽  
Vaccine Failure ◽  
Safety And Efficacy ◽  
First Case ◽  
Relapsing Remitting ◽  
Relapsing Remitting Multiple Sclerosis

Vaccines will play a key role in ending the COVID-19 pandemic. Vaccination against infections remains an important part of the management of patients with multiple sclerosis. However, there are limited data about the safety and efficacy of the currently available COVID-19 mRNA vaccines in patients with multiple sclerosis receiving concurrent immunosuppressive therapies. Patients on B cell depleting therapy such as ocrelizumab have an attenuated vaccine response. We report the first case of COVID-19 vaccine failure in a patient with relapsing-remitting multiple sclerosis on B cell depleting therapy, ocrelizumab. We offer suggestions to improve vaccine efficacy in these patients.

scholarly journals The Immunological Therapeutic Strategies for Controlling Multiple Sclerosis: Considerations during the COVID-19 Pandemic

Biomolecules ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1372
Author(s):  
Maryam Azimzadeh ◽  
Nora Möhn ◽  
Sajjad Ghane Ezabadi ◽  
Zahra Moghimi Esfandabadi ◽  
Alireza Soleimani ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
At Risk ◽  
Severe Acute Respiratory Syndrome ◽  
Immunosuppressive Therapy ◽  
Immunosuppressive Drugs ◽  
Therapeutic Strategies ◽  
Published Data ◽  
Growing Body

A growing body of evidence initially suggested that patients with multiple sclerosis (MS) might be more susceptible to coronavirus disease 2019 (COVID-19). Moreover, it was speculated that patients with MS treated with immunosuppressive drugs might be at risk to develop a severe diseases course after infection with the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV2). However, the recently published data have shown that MS patients do not have a higher risk for severe COVID-19. Although there is no indication that patients with MS and immunomodulatory/immunosuppressive therapy are generally at a higher risk of severe COVID-19, it is currently being emphasized that the hazards of poorly treated MS may outweigh the putative COVID-19 dangers. In this review, we discuss the challenges and considerations for MS patients in the COVID-19 pandemic.

scholarly journals Anti-severe acute respiratory syndrome coronavirus-2 antibody responses following Pfizer-BioNTech vaccination in a patient with multiple sclerosis treated with ocrelizumab: a case report

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110443
Author(s):  
Hubert Mado ◽  
Katarzyna Kubicka-Bączyk ◽  
Monika Adamczyk-Sowa
Keyword(s):  
Multiple Sclerosis ◽  
Immune Response ◽  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Immune Responses ◽  
B Lymphocyte ◽  
Neurological Society ◽  
Antibody Responses ◽  
Post Vaccination ◽  
Lymphocyte Depletion

Patients with multiple sclerosis (MS) repeatedly receive therapies that cause B-lymphocyte depletion. This may lead to abnormal immune responses following coronavirus disease 2019 (COVID-19) vaccination, as has been suggested previously. We therefore evaluated post-vaccination immune responses in a patient with MS treated with ocrelizumab. The intervals between ocrelizumab infusions and vaccination were as recommended by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society. A reactive immune response was observed in this patient following vaccination. This suggests that appropriate intervals between ocrelizumab infusions and COVID-19 vaccinations may permit the generation of efficacious immune responses in patients receiving B-lymphocyte depleting therapies.

scholarly journals Infection in asymptomatic carriers of SARS-CoV-2 can interfere with the achievement of robust immunity on a population scale

2021 ◽  
Vol 102 (11) ◽  
Author(s):  
Kelvinson Viana ◽  
Luis Zarpelon ◽  
Andre Leandro ◽  
Maria Terencio ◽  
Renata Lopes ◽  
...  
Keyword(s):  
Immune Response ◽  
Severe Acute Respiratory Syndrome ◽  
Cellular Immunity ◽  
Cellular Immune Response ◽  
Herd Immunity ◽  
Border Region ◽  
Asymptomatic Carriers ◽  
Population Scale ◽  
Cellular Immune ◽  
First Contact

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread worldwide as a severe pandemic, and a significant portion of the infected population may remain asymptomatic. Given this, five surveys were carried out between May and September 2020 with a total of 3585 volunteers in the municipality of Foz do Iguaçu, State of Paraná, a triple border region between Brazil/Argentina/Paraguay. Five months after the first infection, volunteers were re-analysed for the production of IgG anti-Spike and anti-RBD-Spike, in addition to analyses of cellular immunity. Seroconversion rates ranged from 4.4 % to a peak of 37.21 % followed by a reduction in seroconversion to 21.1 % in September, indicating that 25 % of the population lost their circulating anti-SARS-CoV-2 antibodies 3 months after infection. Analyses after 5 months of infection showed that only 17.2 % of people still had anti-RBD-Spike antibodies, however, most volunteers had some degree of cellular immune response. The strategy of letting people become naturally infected with SARS-CoV-2 to achieve herd immunity is flawed, and the first contact with the virus may not generate enough immunogenic stimulus to prevent a possible second infection.

scholarly journals A challenging complication following SARS-CoV-2 infection: a case of pulmonary mucormycosis

Infection ◽  
2020 ◽  
Author(s):  
Daniela Pasero ◽  
Silvana Sanna ◽  
Corrado Liperi ◽  
Davide Piredda ◽  
Gian Pietro Branca ◽  
...  
Keyword(s):  
Immune Response ◽  
Severe Acute Respiratory Syndrome ◽  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Opportunistic Infections ◽  
Immunocompromised Patients ◽  
Pulmonary Mucormycosis ◽  
First Case

AbstractSevere acute respiratory syndrome coronavirus 2 infection might induce a significant and sustained lymphopenia, increasing the risk of developing opportunistic infections. Mucormycosis is a rare but severe invasive fungal infection, mainly described in immunocompromised patients. The first case of a patient diagnosed with coronavirus disease (COVID-19) who developed a pulmonary mucormycosis with extensive cavitary lesions is here reported. This case highlights how this new coronavirus might impair the immune response, exposing patients to higher risk of developing opportunistic infections and leading to worse outcomes.

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