Humoral Response to SARS-CoV-2 Antigen in Patients Treated with Monoclonal Anti-CD20 Antibodies: It Is Not All about B Cell Recovery

Round 1

Reviewer 1 Report

The article Julia Feige et al., is written in good scientific language. Contains a sufficient number of illustrations. It will be interesting to specialists.

I believe that this review is dedicated to a relevant topic. This is an important question to understand how anti-CD20 medications can affect the humoral response against sars-cov-2. Every year there are more and more people using this kind of therapy and we need to understand how it works

The results obtained allowed the authors that peripheral B cells are required to generate pathogen specific antibodies to neo-antigens but not for recall response in patients treated with anti-CD20 therapy.

The links to the articles used by the authors relate to the subject area and reflect the current understanding of the problem.

The figures and tables are prepared properly and do not raise any questions.

Author Response

Dear Sir or Madam,

thank you so much for your helpful and kind review report.

Reviewer 2 Report

I reviewed the article entitled « Humoral response to SARS-CoV-2 antigen in patients treated with monoclonal anti-CD20 antibodies: It is not all about B cell recovery». The topic is interesting, and the paper fits the Journal's scope and formal requirements (except for the Abstract section, which exceeds the maximum word limits, I suggest reducing the length for better clarity). The article is well structured, and the sequence of its presentation is clear.

Please answer the following comments :

« Of the remaining six individuals (“others”), five patients had been diagnosed with NMOSD and one patient was considered to suffer from an inflammatory CNS disease with unknown etiology; however, a progressive disease course of MS was among the differentials ».

·       Were your results confirmed only when analyzing the 74 MS patients?

·       If those analyses were performed, I suggest adding the data in the results section.

·       Please also better justify why you included the patient with undefined inflammatory disease since most reported literature focuses on MS and /or NMOSD.

Do you find any differences when stratifying for Rituximab versus Ocrelizumab? Could the different treatments have affected the results?

Were any differences in the demographic features and characteristics among the three cohorts ( i.e mean intervals between the last infusion and B cell count or mean intervals between last SARS-CoV-2 contact and antibody assessment )?

Could you add a p-value column in table 1 if relevant differences are present or specify that no differences were present?

 

 

My final decision is minor revisions.

Author Response

Dear Sir or Madam,

thank you very much for your helpful review report.

 

Point 1:

« Of the remaining six individuals (“others”), five patients had been diagnosed with NMOSD and one patient was considered to suffer from an inflammatory CNS disease with unknown etiology; however, a progressive disease course of MS was among the differentials ».

• Were your results confirmed only when analyzing the 74 MS patients?
• If those analyses were performed, I suggest adding the data in the results section.
• Please also better justify why you included the patient with undefined inflammatory disease since most reported literature focuses on MS and /or NMOSD.

Response 1:

We did not analyse the MS patients separately.
Regarding the remaining patient with „inflammatory CNS disease with unknown etiology“: this was the „official diagnosis“; however, we included the patient as we believed them to suffer from a progressive MS disease course as well.

 

Point 2:

Do you find any differences when stratifying for Rituximab versus Ocrelizumab? Could the different treatments have affected the results?

Response 2:

There were no statistically significant differences.

 

Point 3:

Were any differences in the demographic features and characteristics among the three cohorts ( i.e mean intervals between the last infusion and B cell count or mean intervals between last SARS-CoV-2 contact and antibody assessment )?

Response 3:

There were no statistically significant differences.

 

Author Response File: Author Response.docx