To be or not to be vaccinated: The risk of MS or NMOSD relapse after COVID-19 vaccination and infection.
Acute relapse
COVID-19
Multiple sclerosis
Neuromyelitis optica
Vaccination
Journal
Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
13
03
2022
revised:
08
06
2022
accepted:
01
07
2022
pubmed:
9
7
2022
medline:
8
9
2022
entrez:
8
7
2022
Statut:
ppublish
Résumé
COVID-19 vaccination and infection are speculated to increase the activity of immune-mediated diseases, including multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). The aim of this study was to evaluate a short-term risk of relapse after COVID-19 vaccination and COVID-19 infection in patients with these demyelinating disorders of the central nervous system and to determine disease exacerbation risk factors. Data in this retrospective, observational cohort study was collected via the Czech nationwide registry ReMuS from March 1, 2020, to October 30, 2021. We compared the proportion of patients with at least one clinical relapse in the 90 days following vaccination or infection to the 90-day intervals during the year before. For the evaluation of the risk factors of relapse, a comparison between groups with and without relapses after COVID-19 vaccination or infection was made. We identified 1661 vaccinated (90.11% BNT162b2) patients with MS without a history of COVID-19 and 495 unvaccinated patients with MS who experienced COVID-19. A mild increase in the proportion of patients with at least one clinical relapse (-360 to -270 days: 4.46%; -270 to -180: 4.27%; -180 to -90: 3.85%; -90 to 0: 3.79% vs. 0 to +90 days: 5.30%) after vaccination in patients with MS was observed, as well as a rise in the proportion of patients with at least one clinical relapse after COVID-19. Lower age was associated with MS relapse after vaccination or infection. Although there were only 17 vaccinated and eight post-COVID-19 patients with NMOSD, the results were broadly consistent with those of patients with MS. There is a mild increase in the relapse incidence after the COVID-19 vaccination. The risks, however, need to be balanced against the risks of COVID-19 itself, also leading to the rise in relapse rate and particularly to morbidity and mortality.
Sections du résumé
BACKGROUND
BACKGROUND
COVID-19 vaccination and infection are speculated to increase the activity of immune-mediated diseases, including multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). The aim of this study was to evaluate a short-term risk of relapse after COVID-19 vaccination and COVID-19 infection in patients with these demyelinating disorders of the central nervous system and to determine disease exacerbation risk factors.
METHODS
METHODS
Data in this retrospective, observational cohort study was collected via the Czech nationwide registry ReMuS from March 1, 2020, to October 30, 2021. We compared the proportion of patients with at least one clinical relapse in the 90 days following vaccination or infection to the 90-day intervals during the year before. For the evaluation of the risk factors of relapse, a comparison between groups with and without relapses after COVID-19 vaccination or infection was made.
RESULTS
RESULTS
We identified 1661 vaccinated (90.11% BNT162b2) patients with MS without a history of COVID-19 and 495 unvaccinated patients with MS who experienced COVID-19. A mild increase in the proportion of patients with at least one clinical relapse (-360 to -270 days: 4.46%; -270 to -180: 4.27%; -180 to -90: 3.85%; -90 to 0: 3.79% vs. 0 to +90 days: 5.30%) after vaccination in patients with MS was observed, as well as a rise in the proportion of patients with at least one clinical relapse after COVID-19. Lower age was associated with MS relapse after vaccination or infection. Although there were only 17 vaccinated and eight post-COVID-19 patients with NMOSD, the results were broadly consistent with those of patients with MS.
CONCLUSION
CONCLUSIONS
There is a mild increase in the relapse incidence after the COVID-19 vaccination. The risks, however, need to be balanced against the risks of COVID-19 itself, also leading to the rise in relapse rate and particularly to morbidity and mortality.
Identifiants
pubmed: 35803085
pii: S2211-0348(22)00523-5
doi: 10.1016/j.msard.2022.104014
pmc: PMC9250417
pii:
doi:
Substances chimiques
COVID-19 Vaccines
0
BNT162 Vaccine
N38TVC63NU
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
104014Commentaires et corrections
Type : CommentIn
Type : ErratumIn
Informations de copyright
Copyright © 2022 Elsevier B.V. All rights reserved.
Références
Eur Rev Med Pharmacol Sci. 2021 Feb;25(3):1663-1669
pubmed: 33629336
Mult Scler. 2021 May;27(6):864-870
pubmed: 33856242
Mult Scler Relat Disord. 2022 Feb;58:103424
pubmed: 35216793
Neurol Neuroimmunol Neuroinflamm. 2021 Mar 16;8(3):
pubmed: 33727311
Mult Scler Relat Disord. 2021 Jul;52:102947
pubmed: 33979771
N Engl J Med. 2021 Feb 4;384(5):403-416
pubmed: 33378609
J Neurol Neurosurg Psychiatry. 2022 Apr;93(4):448-450
pubmed: 34408003
Mult Scler Relat Disord. 2022 Jan;57:103320
pubmed: 35158424
N Engl J Med. 2020 Dec 31;383(27):2603-2615
pubmed: 33301246
Mult Scler Relat Disord. 2022 Jan;57:103359
pubmed: 35158468
Lancet. 2021 Jan 9;397(10269):99-111
pubmed: 33306989
N Engl J Med. 2021 Jun 10;384(23):2187-2201
pubmed: 33882225
J Autoimmun. 2022 Jun;130:102830
pubmed: 35461018
Mult Scler Relat Disord. 2022 Feb;58:103394
pubmed: 35216775
Am J Prev Med. 2011 Aug;41(2):121-8
pubmed: 21767718
Mult Scler Relat Disord. 2021 Sep;54:103104
pubmed: 34216998
Neurology. 2006 Aug 22;67(4):652-9
pubmed: 16870812
J Neurol. 2022 May;269(5):2275-2285
pubmed: 34984514
Subcell Biochem. 2019;91:21-43
pubmed: 30888648
N Engl J Med. 2001 Feb 1;344(5):319-26
pubmed: 11172162
J Immunol Methods. 2018 Dec;463:21-26
pubmed: 30114401
Mult Scler Relat Disord. 2019 Oct;35:196-202
pubmed: 31400559
Vaccines (Basel). 2021 Apr 29;9(5):
pubmed: 33946748
Mult Scler Relat Disord. 2020 Nov;46:102522
pubmed: 33007726
Eur J Neurol. 2021 Nov;28(11):3742-3748
pubmed: 34288285
Mult Scler Relat Disord. 2022 Jan;57:103321
pubmed: 35158439
Mult Scler Relat Disord. 2021 Oct;55:103189
pubmed: 34375861
Mult Scler Relat Disord. 2021 Jun;51:102915
pubmed: 33799284
Front Neurol. 2022 Jan 27;12:820723
pubmed: 35153993