What is common to MDA5 and COVID-19?

Respiratory complaints and nonspecific systemic symptoms combined with bilateral ground glass opacities on chest imaging constitute the clinical and radiological picture of both COVID-19 disease and anti-MDA5 dermatomyositis. Those findings together with the identification of anti-MDA5 antibodies in sera of certain COVID-19-positive patients allude for a common immunogenic basis. The common pathophysiological denominator is the cytokine storm. Modulation of interferon beta pathway plays role in both diseases;this observation can direct us for potential immunomodulatory therapies for both COVID-19 and anti-MDA5 dermatomyositis. This chapter will discuss in detail the clinical, radiological, and laboratory similarities of both COVID-19 disease and anti-MDA5 dermatomyositis. © 2023 Elsevier Inc. All rights reserved.

Safety and efficacy of COVID-19 Pfizer-BNT162b2 m-RNA vaccine in young MS population

Introduction: As the vaccination against coronavirus disease 2019 (COVID-19) becomes available worldwide, risks related to vaccinating patients with multiple sclerosis (MS) need to be carefully assessed. Objective: Characterize safety and occurrence of immediate relapses following COVID-19 vaccination in young MS patients up to 30 years of age. Methods: We assessed the safety of BNT162b2-COVID-19 vaccination in young MS patients. Patients were contacted by phone, email, WhatsApp, or face-to-face encounters. Follow-up was conducted in the MS Center to record any occurrence of acute relapses Results: The safety profile of COVID-19 vaccination was compared between 21 very young and 71 young MS patients, median (25-75 IQR) age 18.7 (18.1 - 19.8) vs. 26.5 (24.2 - 28.3) years, p<0.001. One patient (4.8%) in the very young age group was infected with SARS-COV-2 following the first vaccine dose;no cases of COVID-19 infection were noted during the follow-up, median (range) 85 (7 - 116) days after the second vaccine dose. The percent of patients with any adverse event was higher in the very young age group, after the first and the second vaccine doses, 76.2% and 80.9% vs. 52.1% and 59.1%, respectively. Adverse events profile was characterized by increased rates of pain at the injection site fatigue, and headache in the very young age group, after the first and after the second vaccine doses. No events of face tingling or facial palsy were recorded in either age group. No increased risk of relapse activity was noted in both groups. Conclusions: The COVID-19-BNT162b2 vaccine is safe for young MS patients. The frequency of adverse events was higher in the very young age group, and more so after the second vaccine dose.

COVID-19 vaccination in patients with multiple sclerosis: What we have learnt by May 2021

Introduction: We have previously reported (Achiron A, et al. Mult Scler. 2021. PMID: 33856242) that the BNT162b2 vaccine against coronavirus disease 2019 (COVID-19) proved safe for multiple sclerosis (MS) patients, with no increased risk of relapse activity. Since our previous report, further data has accumulated, and the follow-up period was extended. Objectives: Revalidate safety and occurrence of immediate relapses following COVID-19 vaccination in a large cohort of MS patients. Methods: We assessed the safety of BNT162b2 COVID-19 vaccination in adult MS patients. Patients were questioned regarding adverse events via phone, WhatsApp, email, or face-to-face encounters. Follow-up was conducted in the MS Center to record any occurrence of acute relapses. Results: Between December 2020 and April 2021, 911 MS patients received the first vaccine dose and 888 completed the second dose. Four cases of COVID-19 infection were encountered after the first dose. The adverse event profile of COVID-19 vaccine was mainly characterized by pain at the injection site (23.1% and 15.6% of patients following first and second dose, respectively), fatigue (10.3%, 19.4%), and headache (5.5%, 8.1%). An acute relapse was noted in 1.5% of patients adjacent to the first dose. Within a follow-up period of up to 4 months from second vaccine dose, 3.1% of patients experienced an acute relapse, median 41 days from second dose. The rate of acute relapses during the follow-up period was similar between vaccinated and nonvaccinated MS patients (4.6%). Younger age (18-55 years), lower disability (Expanded Disability Status Scale ≤3.0), and treatment with immunomodulatory medication were associated with a higher frequency of adverse events. Conclusions: COVID-19 BNT162b2 vaccine is safe for MS patients. No increased risk of acute relapse activity was noted following vaccination.