Inojosa Hernan, Schriefer Dirk, Atta Yassin, Dillenseger Anja, Proschmann Undine, Schleußner Katharina, Woopen Christina, Ziemssen Tjalf, Akgün Katja
Center of Clinical Neurosciences, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, 01307 Dresden, Germany.
Vaccines (Basel). 2024 Mar 3;12(3):265. doi: 10.3390/vaccines12030265.
The SARS-CoV-2 pandemic profoundly impacted people with multiple sclerosis (pwMS). Disease-related aspects and demographic factors may influence vaccination rates, infection susceptibility, and severity. Despite prior research, comprehensive real-world data obtained throughout the pandemic remain limited. We investigated SARS-CoV-2 vaccination and infection patterns in a large monocentric real-world cohort. We collected prospective data from medical visits at the MS Center Dresden, Germany, from the pandemic's beginning until 31 May 2022. Logistic regression and rank correlation analyses were used to explore associations between SARS-CoV-2 outcomes and patient characteristics. Of 2115 pwMS assessed (mean age 46.5, SD ± 12.9; median expanded disability status scale 2.5), 77.9% were under disease-modifying treatment (DMT), primarily B-cell depletion (25.4%). A total of 35.5% reported SARS-CoV-2 infections, and 77.4% were fully vaccinated. PwMS with increased disability, older age, and comorbidities were associated with higher vaccination rates, possibly due to the awareness of these populations regarding complications of SARS-CoV-2 infections. Infections were more common in younger females, people with a lower degree of disability, those with relapsing MS, and those who were not vaccinated. PwMS on B-cell depletion reported more infections than untreated pwMS and those receiving other types of disease-modifying therapy, despite higher vaccination rates. Most infections were mild, with no severity differences according to demographic or disease-related factors, except for gender. Notably, all fatal cases occurred in unvaccinated pwMS. Our studies suggest that demographic and disease-related factors, especially age and the use of B-cell depletion, significantly influenced SARS-CoV-2 vaccination and infection rates in our cohort. These factors may be considered in future preventive campaigns in further pandemics.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行对多发性硬化症患者（pwMS）产生了深远影响。与疾病相关的因素和人口统计学因素可能会影响疫苗接种率、感染易感性和严重程度。尽管之前有相关研究，但在整个大流行期间获得的全面真实世界数据仍然有限。我们在一个大型单中心真实世界队列中调查了SARS-CoV-2疫苗接种和感染模式。我们收集了从大流行开始至2022年5月31日期间在德国德累斯顿多发性硬化症中心就诊的前瞻性数据。采用逻辑回归和等级相关分析来探讨SARS-CoV-2相关结果与患者特征之间的关联。在评估的2115例pwMS患者中（平均年龄46.5岁，标准差±12.9；扩展残疾状态量表中位数为2.5），77.9%接受疾病修饰治疗（DMT），主要是B细胞清除治疗（25.4%）。共有35.5%的患者报告感染了SARS-CoV-2，77.4%的患者完成了全程接种。残疾程度增加、年龄较大和患有合并症的pwMS患者疫苗接种率较高，这可能是由于这些人群对SARS-CoV-2感染并发症的认知。感染在年轻女性、残疾程度较低的人群、复发型MS患者以及未接种疫苗的人群中更为常见。尽管疫苗接种率较高，但接受B细胞清除治疗的pwMS患者报告的感染比未治疗的pwMS患者和接受其他类型疾病修饰治疗的患者更多。大多数感染为轻症，除性别外，根据人口统计学或疾病相关因素没有严重程度差异。值得注意的是，所有死亡病例均发生在未接种疫苗的pwMS患者中。我们的研究表明，人口统计学和疾病相关因素，尤其是年龄和B细胞清除治疗的使用，对我们队列中的SARS-CoV-2疫苗接种和感染率有显著影响。在未来应对进一步大流行的预防行动中可能需要考虑这些因素。
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