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
Objective: Our objective was to assess the level of depression and HRQoL of MS patients and compare it with the 2019 pre-pandemic assessment. Background: Multiple Sclerosis (MS) is a disabling chronic disease with clinical heterogeneity and uncertain prognosis. Evaluating the health-related quality of life (HRQoL) of patients is important for the multidisciplinary therapeutic approach including physical, psychic and social aspects that influence the well-being of people with consequences in the course of the disease. As of March 2020 due to the Coronavirus 2019 (COVID-19) pandemic and quarantine measures, habits and access to the health system have been substantially modified. Design/Methods: A cross-sectional study was conducted. A virtual survey assessed HRQoL with the “Multiple Sclerosis International Quality of Life questionnaire” (MusiQol), depression with the Beck Depression Inventory II (BDI-II), and pandemic-related aspects using a questionnaire designed for this study. The results of MusiQol and BDI-II were compared with those obtained from the 2019 evaluations. Results: We evaluated 62 patients. In the comparative analysis with 2019, a significant decrease in HRQoL was observed (z=-2.21, p=0.03). The affected domains were activities of daily living, psychological well-being, and sexual and sentimental life. In contrast, no significant changes were observed in the assessment of depression using BDI-II (z=-0.39, p=0.69). Conclusions: HrQoL of MS patients is decreased compared to 2019. The pandemic itself, health and quarantine measures have negatively impacted HRQoL, substantially impairing patients' performance in activities of daily living, psychological well-being, and sexual and sentimental life.