Longitudinal quantification of serum SARS-CoV-2 neutralising antibodies, pro-inflammatory cytokines, NfL and GFAP before and after breakthrough COVID-19 infection in CNS neuroimmunological diseases: a prospective observational study

Sep 12, 2025Therapeutic advances in infectious disease

Changes in COVID-19 antibodies, inflammation markers, and brain injury proteins before and after breakthrough infection in people with central nervous system immune diseases

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Abstract

Sixty-one patients with central nervous system neuroimmunological diseases participated in the study.

  • Patients on anti-CD20 or sphingosine-1-phosphate-receptor modulators exhibited significantly lower levels of neutralizing antibodies following the fourth vaccine dose and after COVID-19 infection compared to those on other immunotherapies.
  • No significant changes were observed in the levels of interleukin-6 and tumor necrosis factor between baseline and post-COVID-19 infection.
  • In patients with relapsing-remitting multiple sclerosis and neuromyelitis optica spectrum disorder, and levels did not differ between baseline and post-COVID-19 infection.

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Key numbers

2.1%
Decrease in levels post-
Median levels in patients on after .
1.9%
Decrease in levels post-COVID-19 infection
Median levels in patients on after COVID-19 infection.
61 patients
Study population size
Total number of patients included in the analysis.

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