ABSTRACT
Introduction: Most reports related to humoral immune response to COVID 19 vaccines in people with Multiple Sclerosis (pwMS) were performed on mRNA-based vaccines. Objective(s): to analyze the longitudinal humoral immune responses to adenovirus-based vaccines (Sputnik V and AZD1222) in pwMS under different diseases modifying therapies (DMTs) Methods: IgG anti- SARS-COV-2 spike titers in a cohort of 101 pwMS and 28 healthy controls (HC) were measured 6 weeks after vaccination using the COVID-AR kit according to the manufacture instructions. Both patients and controls received two or three doses of Sputnik, AZD1222 or a mixed schedule (MS) of both vaccines. The neutralizing capacity was evaluated by measuring antibody neutralizing titers using SARS COV-2 pseudotyped particles. Result(s): 60.5% of pwMS were female, mean EDSS: 2.49 +/-1.5, age: 36.6 +/-10.7, disease duration 7.6 +/- 5.1 years. DMTs: 45 pwMS were under fingolimod, 23 under dimethyl fumarate, 14 under cladribine and 19 under antiCD20 monoclonal antibodies. Vaccines: 35.7% Sputnik V, 51.9% AZD1222 and 12.4 % MS. No antibody response to a 2nd dose was found in 41.3% of pwMS under fingolimod and 73.6% under antiCD20. We found a correlation between lower lymphocyte count and lower antibody titers in pwMS under fingolimod (r: 0.67, 95% CI: 0.46-0.81, p=<=0.0001). A correlation was also found between the antibody titer and the last dose of antiCD20 (r: 0.49, 95% CI: 0.03-0.7, p=0.03). In March 2022, 57 pwMS received their 3nddose, 6 patients under fingolimod and 7 under antiCD20 remained without any antibody response. We did not find differences in the neutralization capacity with different DMT and or vaccines. Multivariate regression analysis showed antiCD20 (beta= -,349, 95% CI: -3655.6-369.01, p=0.017) and fingolimod (beta=-,399, 95% CI: -3363.8-250.9, p=0.023) treatments as independent factor associated with low antibody response (r2 adjusted=0.157). Conclusion(s): This is the first report of longitudinal humoral immune response of patients under adenovirus-based vaccines, specially Sputnik V, that demonstrate that these vaccines have similar results to those obtained with mRNA-based vaccines.
ABSTRACT
Introduction: The coronavirus 2019 pandemic represented a great challenge for the health system. The demand for hospital beds and resources for the treatment of the coronavirus has forced the health service to reorganize and the National Government to implement strict measures to reduce the rate of infections. Objective: The objective of the study was to determine whether the care and access to medication of patients with epilepsy was affected during mandatory quarantine. Materials and methods: This is a cross-sectional study that was conducted in two medical health centers, one public and one private, in the Autonomous City of Buenos Aires, Argentina. A survey was designed in the Google Forms platform and sent by email between April and June 2020 to patients with epilepsy treated in both institutions. Questions on demographic characteristics, access to the health care system and changes in the frequency of seizures were included. Results: 488 patients were contacted, obtaining a response of 50.8%. Regarding the health care coverage, 36.5% of the patients did not have any. 49.1% had problems accessing to the medications. 29.7% of the patients contacted referred an increase in the frequency of seizures. The main contact method used was email (35%) and telephone (15.4%). 58% obtained their prescriptions by alternative methods while 13% reported not having access to them. Conclusions: Our results reflect the importance of incorporating alternative means of communication in special situations to guarantee the care and treatment of patients with chronic diseases.