SARS-CoV-2 serology after COVID-19 in multiple sclerosis: An international cohort study

Mult Scler. 2022 Jun;28(7):1034-1040. doi: 10.1177/13524585211035318. Epub 2021 Jul 30.


Background: The MuSC-19 project is an Italian cohort study open to international partners that collects data on multiple sclerosis (MS) patients with COVID-19. During the second wave of the pandemic, serological tests became routinely available.

Objective: To evaluate the seroprevalence of anti-SARS-CoV-2 antibodies according to the use of disease-modifying therapy (DMT) in a subset of patients included in the MuSC-19 data set who had undergone a serological test.

Methods: We evaluated the association between positive serological test results and time elapsed since infection onset, age, sex, Expanded Disability Status Scale score, comorbidities and DMT exposure using a multivariable logistic model.

Results: Data were collected from 423 patients (345 from Italy, 61 from Turkey and 17 from Brazil) with a serological test performed during follow-up. Overall, 325 out of 423 tested patients (76.8%) had a positive serological test. At multivariate analysis, therapy with anti-CD20 was significantly associated with a reduced probability of developing antibodies after COVID-19 (odds ratio (OR) = 0.20, p = 0.002).

Conclusion: Patients with MS maintain the capacity to develop humoral immune response against SARS-COV-2, although to a lesser extent when treated with anti-CD20 drugs. Overall, our results are reassuring with respect to the possibility to achieve sufficient immunization with vaccination.

Keywords: Multiple sclerosis; Sars-COV-2; coronavirus; immunomodulatory therapies; immunosuppressive therapies.

MeSH terms

  • Antibodies, Viral
  • COVID-19*
  • Cohort Studies
  • Humans
  • Multiple Sclerosis* / drug therapy
  • Multiple Sclerosis* / epidemiology
  • SARS-CoV-2
  • Seroepidemiologic Studies


  • Antibodies, Viral