Antibody response after COVID-19 vaccination in intravenous immunoglobulin-treated immune neuropathies.

BACKGROUND AND PURPOSE: This study assessed the prevalence of anti-SARS-CoV-2 antibodies in therapeutic immunoglobulin and their impact on serological response to COVID-19 mRNA vaccine in patients with intravenous immunoglobulin (IVIg)-treated chronic immune neuropathies. METHODS: Forty-six samples of different brands or lots of IVIg or subcutaneous IgG were analyzed for anti-SARS-CoV-2 IgG using enzyme-linked immunosorbent assay and chemiluminescent microparticle immunoassay. Blood sera from 16 patients with immune neuropathies were prospectively analyzed for anti-SARS-CoV-2 IgA, IgG, and IgM before and 1 week after IVIg infusion subsequent to consecutive COVID-19 mRNA vaccine doses and after 12 weeks. These were compared to 42 healthy subjects. RESULTS: Twenty-four (52%) therapeutic immunoglobulin samples contained anti-SARS-CoV-2 IgG. All patients with immune neuropathies (mean age = 65 ± 16 years, 25% female) were positive for anti-SARS-CoV-2 IgG after COVID-19 vaccination. Anti-SARS-CoV-2 IgA titers significantly decreased 12-14 weeks after vaccination (p = 0.02), whereas IgG titers remained stable (p = 0.2). IVIg did not significantly reduce intraindividual anti-SARS-CoV-2 IgA/IgG serum titers in immune neuropathies (p = 0.69). IVIg-derived anti-SARS-CoV-2 IgG did not alter serum anti-SARS-CoV-2 IgG decrease after IVIg administration (p = 0.67). CONCLUSIONS: Our study indicates that IVIg does not impair the antibody response to COVID-19 mRNA vaccine in a short-term observation, when administered a minimum of 2 weeks after each vaccine dose. The infusion of current IVIg preparations that contain anti-SARS-CoV-2 IgG does not significantly alter serum anti-SARS-CoV-2 IgG titers.

[Neuromuscular complications of SARS-CoV-2 infection-Part 2: muscle disorders]. / Neuromuskuläre Komplikationen einer SARS-CoV-2-Infektion ­ Teil 2: Erkrankungen der Muskulatur.

Apart from disorders and diseases of the peripheral nerves, symptoms and disorders of the musculature and the neuromuscular transmission have also been described in association with coronavirus disease 2019 (COVID-19). In the second part of our review we provide an overview about frequently reported symptoms, such as myalgia as well as defined disorders, such as rhabdomyolysis, myositis, myasthenia and intensive care unit (ICU)-acquired weakness, which have been described during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections or COVID-19.Furthermore, the criteria for a causality, such as association strength, plausibility, time course, and experimental evidence for a causal association that should be applied for the COVID-19-asssociated neuromuscular conditions described in the two parts of the review are discussed. At present, in addition to anosmia, which is also known in the lay press, myalgia in particular as a nonspecific symptom are frequent sequelae of a symptomatic SARS-CoV­2 infection. Other neuromuscular complications seem to be principally plausible (considering the pathogenesis) but apparently rare consequences of a SARS-CoV­2 infection. Prospective or cohort studies are necessary to confirm a causality and assess the risk.

[Neuromuscular complications of SARS-CoV-2 infections-Part 1: peripheral nerves]. / Neuromuskuläre Komplikationen einer SARS-CoV-2-Infektion ­ Teil 1: periphere Nerven.

In recent months various disorders and diseases of the peripheral nerves (including cranial nerves) and the musculature have been described in association with the pulmonary disease coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the first part of our review the current knowledge about a potential association of a SARS-CoV­2 infection with dysfunction and diseases of cranial and peripheral nerves is discussed. Anosmia, ageusia, motor cranial nerve involvement and Guillain-Barré syndrome (GBS) were described in a temporal association with a SARS-CoV­2 infection. Several studies could show that anosmia and ageusia were frequent symptoms of a SARS-CoV­2 infection. In contrast the failure of other cranial nerves has so far only been sporadically described. A number of case reports and case series indicate a causal association between a SARS-CoV­2 infection and GBS but epidemiological evidence is still lacking.