Aiello Alessandra, Ruggieri Serena, Navarra Assunta, Tortorella Carla, Vanini Valentina, Haggiag Shalom, Prosperini Luca, Cuzzi Gilda, Salmi Andrea, Quartuccio Maria Esmeralda, Altera Anna Maria Gerarda, Meschi Silvia, Matusali Giulia, Vita Serena, Galgani Simonetta, Maggi Fabrizio, Nicastri Emanuele, Gasperini Claudio, Goletti Delia
Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy.
Department of Neurosciences, San Camillo Forlanini Hospital, 00152 Rome, Italy.
Vaccines (Basel). 2024 Aug 19;12(8):926. doi: 10.3390/vaccines12080926.
This study investigated the incidence and severity of SARS-CoV-2 breakthrough infections (BIs) and the time to swab reversion in patients with multiple sclerosis (PwMS) after the booster dose of COVID-19 mRNA vaccines. We enrolled 64 PwMS who had completed the three-dose mRNA vaccine schedule and had never experienced COVID-19 before. Among the 64 PwMS, 43.8% had BIs with a median time since the third vaccine dose of 155 days. BIs occurred more frequently in ocrelizumab-treated patients (64.7%). Patients with a relapsing-remitting MS course showed a reduced incidence of BIs compared with those with a primary-progressive disease ( = 0.002). Having anti-receptor-binding domain (RBD) antibodies represented a protective factor reducing the incidence of BIs by 60% ( = 0.042). The majority of BIs were mild, and the only severe COVID-19 cases were reported in patients with a high Expanded Disability Status Scale score (EDSS > 6). The median time for a negative swab was 11 days. Notably, fingolimod-treated patients take longer for a swab-negativization ( = 0.002). Conversely, having anti-RBD antibodies ≥ 809 BAU/mL and an IFN-γ-specific T cell response ≥ 16 pg/mL were associated with a shorter time to swab-negativization ( = 0.051 and = 0.018, respectively). In conclusion, the immunological protection from SARS-CoV-2 infection may differ among PwMS according to DMTs.
本研究调查了新型冠状病毒2型（SARS-CoV-2）突破性感染（BI）的发生率和严重程度，以及多发性硬化症患者（PwMS）在接种新冠病毒mRNA疫苗加强剂量后拭子转阴的时间。我们招募了64名完成三剂mRNA疫苗接种程序且此前从未感染过新冠病毒的PwMS。在这64名PwMS中，43.8%发生了BI，自第三剂疫苗接种后的中位时间为155天。BI在接受奥瑞珠单抗治疗的患者中更频繁发生（64.7%）。与原发进展型疾病患者相比，复发缓解型多发性硬化病程的患者BI发生率降低（P = 0.002）。具有抗受体结合域（RBD）抗体是一个保护因素，可使BI发生率降低60%（P = 0.042）。大多数BI为轻症，仅在扩展残疾状态量表评分高（EDSS>6）的患者中报告了重症新冠病毒感染病例。拭子转阴的中位时间为11天。值得注意的是，接受芬戈莫德治疗的患者拭子转阴所需时间更长（P = 0.002）。相反，抗RBD抗体≥809 BAU/mL和IFN-γ特异性T细胞反应≥16 pg/mL与拭子转阴时间较短相关（分别为P = 0.051和P = 0.018）。总之，根据疾病修正治疗（DMT）的不同，PwMS对SARS-CoV-2感染的免疫保护可能存在差异。
