ABSTRACT
Purpose : The COVID-19 pandemic led to unprecedented cancellation or alteration of healthcare events and medical conferences around the world. Many ophthalmology conferences transitioned to virtual interfaces, and the impact of this transition on the ophthalmology community is unclear. The authors wish to objectively define the impact of the COVID-19 pandemic on subspecialty ophthalmology conferences. Methods : This study included data from the following five ophthalmology conferences from 2019, 2020, and 2021, as available: American Glaucoma Society (AGS), American Society of Ophthalmic and Plastic Reconstructive Surgery (ASOPRS), American Society of Cataract and Refractive Surgery (ASCRS), North American Neuro-Ophthalmology Society (NANOS), and Women in Ophthalmology (WIO). Data requested from organizations included the following, as available: Number of total conference attendees, number of attendees stratified by level of training, number of attendees stratified by identified gender, and number of research s or presentations (submitted and/or accepted). This study has been approved by the City University of New York Institutional Review Board. Results : In our study, 60% of organizations demonstrated an increase in number of attendees when using a virtual interface compared to their in-person events. 80% of organizations demonstrated a marked increase in attendance by trainees on their virtual interfaces. 60% of organizations displayed a decrease in number of submitted s when using a virtual interface. 40% of organizations experienced an increase in number of accepted posters and presentations through a virtual platform. Conclusions : Virtual conference interfaces have the potential to increase overall attendance and research participation within the ophthalmology community. Organizations should consider a hybrid model that incorporates aspects of both virtual and in-person interfaces to potentially maximize attendance, outreach, dissemination of information, opportunity, and minimize costs.
ABSTRACT
BACKGROUND Little is known about the impact of immunosuppressants on COVID-19 vaccination in patients with immune-mediated inflammatory diseases (IMID). Although humoral response may be attenuated in patients using immunomodulators (IMM) and TNFinhibitors (anti-TNF), data regarding cellular response are scarce and conflicting. This study was aimed to identify immune response to COVID-19 vaccination in IMID patients. METHODS A prospective observational multicentre cohort study was conducted to examine the immunogenicity of mRNA vaccines to SARS-CoV-2 in adult IMID patients using immunosuppressive therapy (anti-TNF, IMM, anti-TNF+IMM, anti-IL12/23, anti-IL-17, anti-IL-23) or no therapy as compared to healthy controls (HC). Patient details and vaccination history were recorded. Blood samples were drawn at 3 time points: before, 3-4 weeks after first and 2 weeks after second vaccination. Humoral immune response to S and RBD proteins were assessed by ELISA. Neutralization was tested against 4 variants of SARS-CoV-2 by surrogate neutralization ELISA. Cellular immune responses were determined based on analysis of 9 secreted cytokines and cytotoxic molecules after stimulation of PBMC with S peptide pools. Response to N protein was used to assess SARS-CoV-2 exposure. RESULTS A total of 159 subjects (133 IMID patients and 26 HC) were included in this study (median age 42 years [IQR 30-53], 52% male). Of 133 IMID patients, 87 had inflammatory bowel disease, 23 psoriatic arthritis, 18 psoriasis, 11 ankylosing spondylarthritis and 4 rheumatoid arthritis. Of these, 44 used anti-TNF, 9 IMM, 18 anti-TNF+IMM, 33 anti-IL-12/23, 9 anti-IL-17, 10 anti-IL-23 therapy and 10 no therapy. All subjects received 2 doses of mRNA vaccines (2x Pfizer, 2x Moderna or mixed) between December 2020 and September 2021. The vast majority of subjects had minimal binding antibody and T cell responses to N, indicating they were COVID-19 naïve. After dose 1, anti-TNF group had lower IL-2 vs untreated IMID (p<0.01), and the anti-IL-23 group had lower IFN-g vs HC (p<0.01), though there was wide variation in responses within groups. Following dose 2, median responses between groups were mostly similar, but antibody responses were significantly lower in patients on anti-TNF as compared to HC in subjects that received two doses of Pfizer (p=0.01). Pooled data for all subjects combined show a higher response to Moderna over Pfizer in ELISA, neutralization and T cell readouts, and a lower response for those over 60 years of age after dose 2. Longer follow-up is in process to monitor the durability of these responses over time and after third dose. CONCLUSION Immune responses after 2 doses of mRNA vaccines in immunocompromised IMID patients largely reach the level of that of HC albeit antibody responses in the anti-TNF group are weaker and with wide variability between subjects within some groups