Massachusetts General Hospital

Author Of 2 Presentations

COVID-19 Late Breaking Abstracts

LB1262 - Low Prevalence of SARS-CoV-2 Antibodies in People with Multiple Sclerosis Residing in Massachusetts (ID 2159)

Abstract

Background

Seroepidemiology is an important tool to characterize the epidemiology and immunobiology of SARS-CoV-2. Most people with multiple sclerosis (MS) are treated with immunomodulators or immunosuppressants, so it is crucial to understand the immune response to the novel SARS-CoV-2 in people with MS.

Objectives

To investigate the prevalence and persistence of the SARS-CoV-2 antibody response in MS and how this relates to MS phenotype and treatment.

Methods

227 consecutive people with MS residing in MA and receiving care at Massachusetts General Hospital or Brigham and Women’s Hospital and 143 of their cohabitants were enrolled May 29-July 23, 2020. In addition, 8 people with MS receiving care elsewhere who tested positive for SARS-CoV-2 nasal swab PCR and 7 cohabitants of that group were enrolled to enrich the sample for select analyses. Each participant remotely submitted a dried blood card for in-house MGH SARS-CoV-2 IgG ELISA assay testing. The assay displays 99.7% sensitivity and 100% specificity >14 days from symptom onset. Participants completed a REDCap questionnaire covering demographics, MS history and treatments, comorbidities, and COVID-19 symptoms and exposure. Antibody prevalence in MS participants will be compared to that in their cohabitants using Pearson’s Chi-squared tests.

Results

The majority of MS participants were characterized as relapsing/remitting (76.8%) and were taking disease modifying therapies (72.6%) at the time of collection. SARS-CoV-2 antibodies were detected in 3.5% of people with MS residing in MA and 6.3% of their cohabitants (X2=1.54, p=0.22). For comparison, ~1.5% of the MA population had tested positive by PCR in this date range. Exposure and treatment data will be presented in 13 cases of antibody discordance between the person with MS and his/her cohabitant; the person with MS was antibody-negative in 10 cases and antibody-positive in 3 cases with discordance. In total there were 6 MS participants and no cohabitants who previously tested positive by nasal swab PCR but lacked antibodies at follow-up. Of the COVID-positive participants (by PCR or antibody), 54.5% (6 of 11) of MS and 88.9% (8 of 9) of cohabitants were asymptomatic (p=0.16).

Conclusions

Antibody prevalence was low overall in people with MS residing in MA. Discordance between MS participants and their cohabitants and lack of detectable antibodies in some people with MS with prior nasal swab PCR positivity suggest SARS-CoV-2 antibodies may be less persistent in people with MS.

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Imaging Poster Presentation

P0543 - Associations between Corpus Callosum Damage, Clinical Disability, and Surface-based Homologous Inter-hemispheric Connectivity in Multiple Sclerosis (ID 1052)

Speakers
Presentation Number
P0543
Presentation Topic
Imaging

Abstract

Background

Axon damage in the corpus callosum (CC) correlates with disability in multiple sclerosis (MS). Surface-based Homotopic Inter-hemispheric Connectivity (sHIC) is a reliable and novel technique that estimates resting state functional connectivity in inter-hemispheric homologous cortical areas. Previously, we demonstrated a correlation between CC atrophy and decreased sHIC.

Objectives

To investigate homologous connectivity in MS and its relationship with clinical disability and CC axonal integrity.

Methods

Multi-shell diffusion and resting state MRI data were collected from 36 MS and 42 healthy control (HC) subjects on an ultra-high gradient CONNECTOM 3T scanner. The CC was segmented into five sections and the cortex was parcellated using the Desikan-Killiany atlas. Probablistic tractography was used to determine structural connectivity between CC segments and the cortex. Axon density, axon diameter, and restricted volume fraction were estimated for each CC segment using the Axcaliber method. sHIC was determined using a surface-based atlas approach to estimate homologous regions. Neurological disability was measured for the MS group using the Expanded Disability Status Scale (EDSS).

Results

A vertex-wise group analysis showed that homologous connectivity was decreased in temporal, parietal, and somatomotor areas in the MS group compared to the HC group (p < 0.001). EDSS scores correlated most strongly with sHIC in the precentral, postcentral, superior temporal, and pericalcarine gyri (r = -0.40, -0.36, -0.34, -0.54; p < 0.05). EDSS scores correlated with the mean sHIC from cortical regions connected to the central CC, posterior CC, and whole CC (r = -0.34, -0.36, -0.34; p < 0.05). In the posterior CC, restricted volume fraction correlated with sHIC in the inferior temporal (r = 0.36, p = 0.03) and superior parietal (r = 0.41, p = 0.01) gyri, and axon density correlated with sHIC in the superior parietal gyrus (r = 0.35, p = 0.04). A vertex-wise general linear model found significant clusters of correlations (p < 0.01) between restricted volume fraction and sHIC in the superior/inferior parietal, superior temporal, and precentral gyri.

Conclusions

Homologous connectivity is reduced in MS. Higher EDSS scores were significantly related to decreased homologous connectivity, notably in the somatomotor area. A structure-function relationship is observed between CC axonal damage, decreased homologous connectivity, and disability in MS.

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Presenter Of 1 Presentation

COVID-19 Late Breaking Abstracts

LB1262 - Low Prevalence of SARS-CoV-2 Antibodies in People with Multiple Sclerosis Residing in Massachusetts (ID 2159)

Abstract

Background

Seroepidemiology is an important tool to characterize the epidemiology and immunobiology of SARS-CoV-2. Most people with multiple sclerosis (MS) are treated with immunomodulators or immunosuppressants, so it is crucial to understand the immune response to the novel SARS-CoV-2 in people with MS.

Objectives

To investigate the prevalence and persistence of the SARS-CoV-2 antibody response in MS and how this relates to MS phenotype and treatment.

Methods

227 consecutive people with MS residing in MA and receiving care at Massachusetts General Hospital or Brigham and Women’s Hospital and 143 of their cohabitants were enrolled May 29-July 23, 2020. In addition, 8 people with MS receiving care elsewhere who tested positive for SARS-CoV-2 nasal swab PCR and 7 cohabitants of that group were enrolled to enrich the sample for select analyses. Each participant remotely submitted a dried blood card for in-house MGH SARS-CoV-2 IgG ELISA assay testing. The assay displays 99.7% sensitivity and 100% specificity >14 days from symptom onset. Participants completed a REDCap questionnaire covering demographics, MS history and treatments, comorbidities, and COVID-19 symptoms and exposure. Antibody prevalence in MS participants will be compared to that in their cohabitants using Pearson’s Chi-squared tests.

Results

The majority of MS participants were characterized as relapsing/remitting (76.8%) and were taking disease modifying therapies (72.6%) at the time of collection. SARS-CoV-2 antibodies were detected in 3.5% of people with MS residing in MA and 6.3% of their cohabitants (X2=1.54, p=0.22). For comparison, ~1.5% of the MA population had tested positive by PCR in this date range. Exposure and treatment data will be presented in 13 cases of antibody discordance between the person with MS and his/her cohabitant; the person with MS was antibody-negative in 10 cases and antibody-positive in 3 cases with discordance. In total there were 6 MS participants and no cohabitants who previously tested positive by nasal swab PCR but lacked antibodies at follow-up. Of the COVID-positive participants (by PCR or antibody), 54.5% (6 of 11) of MS and 88.9% (8 of 9) of cohabitants were asymptomatic (p=0.16).

Conclusions

Antibody prevalence was low overall in people with MS residing in MA. Discordance between MS participants and their cohabitants and lack of detectable antibodies in some people with MS with prior nasal swab PCR positivity suggest SARS-CoV-2 antibodies may be less persistent in people with MS.

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