{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:36:23Z","timestamp":1788957383023,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Coronavirus disease 2019 (COVID\u201019) vaccination has been associated with a dampened humoral and\/or cellular immune response in patients with multiple sclerosis (MS) who were concurrently on disease\u2010modifying treatment (DMT) with B\u2010cell depleting agents or sphingosine\u20101\u2010phosphate receptor modulators (S1PRMs). Our main goal was to investigate the impact of these DMT classes on the clinical effectiveness of COVID\u201019 vaccination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Since March 2020, demographics and clinical data of patients with MS who developed COVID\u201019 have been collected at the Belgian National MS Centre in Melsbroek. Patients were considered to be \u2018protected by vaccination\u2019 if they were (i) fully vaccinated and (ii) tested positive for COVID\u201019 in the period ranging from 14\u2009days to 6\u2009months after the last administered vaccine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On 19 December 2022, 418 COVID\u201019 cases were retrospectively identified in 389 individual patients. Hospitalization and mortality rates resulting from the infection were 10.8% and 2.4%, respectively. Being \u2018unprotected by vaccination\u2019 was significantly associated with a worse COVID\u201019 outcome (i.e., hospitalization and\/or death) in the total cohort (<jats:italic>N<\/jats:italic>\u2009=\u2009418, odds ratio [OR] 3.96), in patients on ongoing DMT other than anti\u2010CD20 agents or S1PRMs (<jats:italic>N<\/jats:italic>\u2009=\u2009123, OR 31.75) and in patients without DMT (<jats:italic>N<\/jats:italic>\u2009=\u2009182, OR 5.60), but not in those receiving anti\u2010CD20 agents (<jats:italic>N<\/jats:italic>\u2009=\u200991, OR 0.39); the S1PRMs subgroup was considered too small (22 infections) for any meaningful analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Coronavirus disease 2019 vaccination protects against severe infection in patients with MS but it was not possible to confirm this effect in those on DMT with B\u2010cell depleting 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