COVID-19 Vaccination Induced Antibody Production in Immunosuppressed Patients with Autoimmune Neurological Disorders

초록

Background: In the Era of the COVID-19 pandemic, patients with immunosuppressants are of particular concern about lower efficacy of vaccination as well as higher risk of COVID-19 infection. Objective:.This study is to compare the COVID-19 vaccination-induced antibody production in patients receiving immunosuppressing agent in neurological disorders with healthy controls. Methods: Twenty-two patients (1 Optic Neuritis, 4 NMO, 10 Multiple sclerosis, 6 Myasthenia gravis and 1 Polymyositis) with neuroimmunological diseases and 58 healthy individuals were enrolled at the time of 3 months (21 patients, 42 healthy controls) or 6 months (1 patient, 16 healthy controls) after Covid-19 vaccination. The SGT anti-SARS-CoV-2 total antibody ELISA kit (Sugentech, Inc., Korea) was used to detect antibodies against nucleocapsid protein (NP) and spike protein S1 receptor-binding domain (RBD) of Covid-19 virus after vaccination. Antibody production was determined to be positive or negative based on the cut-off value of the optical density according to the manufacture’s instruction. Results: Anti-SARS-CoV-2 total antibody was negative in 3 out of 22 immunosuppressed patients (13.6%), but only 1 of 58 healthy controls at 6 months after Astra Zeneca vaccination showed borderline result (1.7%). At 3 months after vaccination, the results of all 42 healthy controls were positive. 2 NMO patients who received Rituximab within 2 weeks before or after second vaccination showed negative results while one patient who received Rituximab 4 weeks after vaccination showed positive result. A patient with MG on azathioprine was antibody negative at 3months after Astra Zeneca vaccination. Conclusion: As in previous reports, the results of this study suggested that immunosuppressive treatment could reduce the efficacy of the Covid-19 vaccine.