Risk and severity of SARS-CoV-2 reinfection among patients with multiple sclerosis vs. the general population: a population-based study

Abstract

Background We conducted this study to compare the risk of reinfection between multiple sclerosis (MS) patients and a control group without MS. Method In this retrospective study, data of all SARS-CoV-2 tests (n = 793,301) and almost all MS patients (n = 10,639) in Isfahan province were collected from January 01, 2020 to August 22, 2021. Of the 2196 MS patients and 793,301 persons from the general population who had been tested at least once, 3 control for each MS patient were identified, leaving 1560 MS patients and 4680 controls without MS. We compared the risk of reinfection after 90 days of a primary infection between those with and without a previous positive COVID-19 test. Results 736 (47.2%) MS patients and 2013 (43.0%) control individuals had at least one positive test. A total of 17 (2.3%) and 22 (1.1%) possible reinfections in MS and control groups were observed. The estimated protection against reinfection in all MS patients, MS patients on rituximab, MS patients on DMTs rather than rituximab, and controls were 68.2% (46.2, 81.2%), 57.4% (− 0.1, 83.1%), 71.5% (45.5, 85.2%), and 82.1% (72.1, 88.5%), respectively. We found no statistically significant difference in estimated protection (p = 0.123) and odd of reinfection (adjusted OR: 2.01 [0.98, 4.08]) between all MS patients and control group. Two patients were hospitalized at first infection but none required hospitalization at reinfection event. Conclusions MS patients on rituximab may be at a greater risk of reinfection. Further studies are required to assess the risk of the second reinfection among the MS population.

Outcome of COVID-19 Infection in Patients With Multiple Sclerosis Who Received Disease-Modifying Therapies: A Systematic Review and Meta-Analysis

“…All of the 23 included studies were case–control studies, and the quality of all of the literature was identified as high according to the NOS ( Table 2 ). These studies were conducted in the the United States (USA), 17 18 19 20 the Netherlands, 21 Austria, 15 Spain, 22 Sweden, 23 24 25 Iran, 26 27 28 Chile, 29 Italy, 9 30 31 France, 30 Australia, 6 Poland, 32 Canada, 33 and Singapore. 34 Fig.…”

Effectiveness of BBIBP-CorV vaccine in preventing SARS-CoV2 infection and severe outcomes in people living with multiple sclerosis: A population-based study

“…Therefore, the level of protection conferred by vaccination in PLWMS with insufficient humoral immunity, particularly those on anti-CD20 agents is unknown. Concerns exist regarding the effectiveness of SARS-CoV-2 vaccines in PLWMS in light of these findings and a slightly decreased protection against SARS-CoV-2 reinfection in this population ( Barzegar et al, 2022 ).…”