ABSTRACT
Objective: To describe the epidemiological and clinical profile of pediatric patients who were treated for suspected COVID-19 infecion, between March and October 2020, at the Hospital Universitario San Ignacio (HUSI), in Bogota, Colombia. Material(s) and Method(s): Cross-sectional design. Description of patients aged 1 month to 1 day before their 18th birthday, assessed between March and October 2020, who were approached by any pediatric care service of a university hospital for suspected COVID-infection. 19, according to current national and institutional protocols. Demographic variables and the reason for consultation of all individuals with suspected infection were recorded. Only when SARS-CoV-2 infection was confirmed were variables related to clinical aspects of the disease and its evolution recorded. Result(s): 920 medical records of pediatric patients with suspected SARS-CoV-2 infection were evaluated, of which there were 157 confirmed cases with COVID-19 infection. The main reason for consultation to suspect infection was fever in 50% of the cases. In patients with virological confirmation, 32.48% of the cases attended required hospital management. MIS-C was suspected in 5 patients who required intensive care unit management. In the evaluated period, there were no deaths associated with COVID-19 infection. Conclusion(s): SARS-CoV-2 infection is related in most cases to a spectrum of mild disease in the pediatric population. This study may be larger than pediatric patients presenting with gastrointestinal rather than respiratory symptoms, and the frequency of renal complications should be taken into account in patients in whom the systemic inflammatory syndrome associated with COVID-19 is suspected.Copyright © 2023 Asociacion Colombiana de Infectologia. All rights reserved.
ABSTRACT
Objective(s): The aim of this study was to study the humoral immune response to SARS-CoV-2 following vaccination in MS patients. Material(s) and Method(s): We performed a prospective study including all MS patients receiving one of the approved COVID-19 vaccines since January to September 2021. Demographic characteristics, MS treatments and adverse events reports after COVID-19 vaccination of vaccinated MS patients were collected. We analyzed the antibody response to SARS-CoV-2 vaccines with a chemiluminescent microparticle immunoassay (CMIA) from Abbot in MS patients with different DMTs at week 3, week 6 and month 3 after the first dose. The positivity cutoff is ≥50 AU/ml (manufacturer defined). 200 Healthy healthcare professionals were the control group. Result(s): We analyzed 165 vaccinated MS patients: 106 with Pfizer, 14 with Moderna, 42 with both doses of Astra zeneca and 3 with Jannsen. The mean age of patients was 45 (range: 21-71) and 46 for the controls. The most frequent adverse events were pain at injection site, headache and fatigue for 24-48 hours. No differences between MS patients and controls. No increased risk of relapse was noted in the first six months. 120 patients have received both doses of mRNA vaccine. Overall, mean antibody titers response to SARS-CoV-2 SARS-CoV-2 at three weeks was 7910,3 AU/mL (range 0-74947), at 6 weeks 16347,9 UA/mL (range:0-52380,5) and at 3 months 8182,10 UA/ml (range:0-33752,4) in mRNA vaccinated patients. By the mRNA vaccinated control group mean antibody titers response to SARS-CoV-2 SARS-CoV-2 at three weeks was 9397 AU/mL and at 6 weeks 18120 UA/mL Performing a subanalysis of the different DMTs: Only 3 out of 20 patients treated with ocrelizumab developed antibodies. Six vaccinated patients treated with rituximab had no antibody response. Four from 16 patients treated with fingolimod failed to develop a post-vaccination humoral response (< 50 AU/ml). 4 of 5 patients treated with ofatumumab developed have an adequate humoral response. Patients treated with interferon Beta, glatiramer acetate, teriflunomide, dimethyl fumarate, vaccinated with mRNA vaccines developed a similar post vaccination humoral response than healthy controls. Conclusion(s): Most of MS treated patients developed enough antibodies to SARS-CoV-2. The adverse events on MS patients were similar to the general population. No increase of relapse activity was observed. Some patients treated with ocrelizumab, rituximab and fingolimod have no developed a humoral response to SARS-CoV-2 vaccination. Hence we conclude that all approved COVID-19 vaccines are safe in MS patients and effective in most patients. However vaccine strategy in patients treated with anti-CD20 and fingolimod need further studies.
ABSTRACT
Introduction: Due to the outbreak of the pandemic, the treatment and management of our patients is a challenge and more now with the Covid-19 vaccination. Objectives : To report our experience with Covid19 vaccines in MS patients and to study the antibody response to SARS-CoV-2 in MS patients. Methods: We performed a prospective study including all MS patients receiving one of approved vaccines since January 2021. Demographic characteristics, treatments and adverse events of vaccinated MS patients were collected. We analyze the developing antibodies to SARS-CoV-2 with an ELISA assay from Abbot in MS patients with different DMTs at week 3, week 6 and month 3 after the first dose. Healthy healthcare professionals were used as a control group. More than 50 UA/ml was considered an adequate immune humoral response. Results: We analyzed 96 vaccinated MS patients: 47 with Pfizer, 6 with Moderna, 42 with Astrazeneca and 1 with Jannsen. Mean age was 45 (range: 21-69). 52 patients have received both doses of mRNA vaccine. Patients have been vaccinated or by age (8,33%), disability (33%), or essential work (62,50%). The most frequent adverse events were paint at injection site, headache and fatigue. No increased risk of relapse was noted in the first three months. 52 patients have received both doses of mRNA vaccine. Patients vaccinated with AstraZeneca have received only the first dose due to public health issues. SARS-CoV-2 titer at three weeks was 7910,3 UA/mL (range 0-74947), at 6 weeks 16347,9 UA/mL (range:0- 52380,5) and at 3 months 8182,10 UA/ml (range:0-33752,4) in mRNA vaccinated patients. Only one from 5 patients treated with ocrelizumab developed antibodies (at 6 weeks 4783 UA/mL, at 3 months1087 UA/mL), the only vaccinated patient treated with rituximab has no antibody response. 3 from 6 patients treated with fingolimod failed to develop a post-vaccination humoral response, the other 3 had a low antibody response. Patients treated with interferon Beta, glatiramer acetate, teriflunomide, dimethyl fumarate, natalizumab and cladribine and vaccinated with mRNA vaccines develop a post vaccination humoral response ( range: 750-21257 UA/mL). Conclusions: Most of treated MS patients develop enough antibodies to SARS-CoV-2. Some patients treated with anti-CD20 and fingolimod failed to develop a post-vaccination humoral response. Adverse events were similar to the general population. No increase of relapse activity was observed.