JCV seroconversion rate during the SARS COVID-19 pandemic.

The transmission route of the John Cunningham virus (JCV) is not clearly understood. The high prevalence of JCV in urine and sewage and the stability of the viral particles observed suggest that contaminated water, food, and fomites could be the vehicles of JCV transmission through the oral route. Multiple Sclerosis (MS) patients treated with Natalizumab are at risk of developing progressive multifocal leukoencephalopathy (PML), and hence, JCV serology is monitored for risk stratification. Social restrictions introduced in 2020 which intended to limit the transmission of SARS-CoV-2 are associated with decreased rates of other communicable diseases, as has been shown in recent observational studies. We evaluated the prevalence of seroconversion prior to and during the coronavirus disease (COVID -19) pandemic based on clinical records of JCV serology status in a single-center cohort of Natalizumab-treated Multiple Sclerosis patients. We hypothesized that seroconversion rates would decrease due to behavioral changes. However, seroconversion rates were stable during the COVID-19 pandemic compared to the pre-pandemic. These findings support the notion that JCV is transmitted via the GI tract rather than the respiratory system.

BNT162b2 mRNA COVID-19 Vaccine Three-Dose Safety and Risk of COVID-19 in Patients With Myasthenia Gravis

Objective To study the COVID-19 vaccine three-dose safety and risk of COVID- 19 in patients with myasthenia gravis Background Various vaccines, including those against SARS-CoV-2, were reported to trigger or exacerbate myasthenia gravis (MG). As COVID-19 may potentially contribute to the tendency of MG patients to develop respiratory failure, it is important to study the safety of vaccines against SARS-CoV-2 and assess the risk of COVID-19 in MG patients. Design/Methods Among 215 MG patients treated in Tel Aviv Medical Center, 160 were interviewed about their response to the three-dose BNT162b2 mRNA vaccine. We assessed exacerbation rate and safety in a period of up to 6 weeks from each vaccine dose, as well as patient morbidity and mortality during COVID-19 compared to the general population. Results 430 vaccine doses were administered across 150 patients. Thirteen patients (8.7%) complained of exacerbation within 6 weeks (risk period) of each vaccine dose, 8 (5.3%) confirmed by physician report. The exacerbation rates were similar during the risk period (5.6%) compared to corresponding period the previous year (4.8%). MG onset rates during the vaccination period were unaffected compared to previous years. Exacerbation rate among 15 patients who had COVID-19 was significantly higher (40%) compared to rate in the risk period following vaccination, with higher severe or lethal COVID-19 (26.7%) compared to the general population (0.96%), occurring in unvaccinated, steroidtreated, generalized MG patients. Conclusions Three-dose BNT162b2 vaccination is neither associated with exacerbation nor the new onset of MG, whereas COVID-19 is associated with severe disease and death in unvaccinated, steroid-treated generalized MG patients. Hence, it is strongly recommended for generalized MG patients to get vaccinated.