Acute Demyelinating Encephalomyelitis Post-COVID-19 Vaccination: A Case Report and Literature Review

Al-Quliti, Khalid W.; Qureshi, Ahmad S; Quadri, Mohammed; Abdulhameed, Babar; Alanazi, Alhanouf; Alhujeily, Rakan M

doi:10.3390/diseases10010013

Cited by 17 publications

(17 citation statements)

References 19 publications

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“…We also summarize case reports of COVID‐19 vaccine‐related encephalomyelitis in Table 4 . 8 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 Similar to our case, the symptoms of encephalitis developed within 30 days after vaccination. After excluding alternative causes, vaccination‐related autoimmune encephalitis was suspected and symptoms rapidly recovered after the initiation of immunosuppressive therapy.…”

Section: Discussionsupporting

confidence: 87%

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Case report of acute encephalitis following the AstraZeneca COVID‐19 vaccine

Chen

Liu

et al. 2022

Int J of Rheum Dis

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In December 2019, a novel coronavirus, SARS-CoV-2, first reported in the Wuhan city of China, soon spread around the world and caused substantial impact on health. As of March 2022, SARS-CoV-2 has infected ~400 million people worldwide and caused 6.07 million deaths. During the global COVID-19 pandemic, people in Taiwan maintained normal lives due to longstanding strategies of masking, personal hygiene, social distancing, quarantine measures and contact tracing. Unfortunately, the community outbreak of COVID-19 in Taiwan began in May 2021. To stop virus transmission, Taiwan Centers for Disease Control made an effort to increase COVID-19 vaccination coverage. Four types of vaccines, including Moderna, AstraZeneca (AZ), Pfizer-Biontech (BNT) and MVC COVID-19Vaccine, are available in Taiwan. Headache is the most common neurological side effect after COVID-19 vaccination. In phase 3 clinical trials, the incidence of headache was 24%-35% and 46%-63% after first and second doses of Moderna vaccination; 1 50.2% after first and second doses of AZ vaccination; 2 and 25%-42% and 39%-52% after first and second doses of BNT vaccination. 3 In s phase 2 clinical trial, the incidence of headache was 15.1% and 13.2% after first and second doses of MVC COVID-19 vaccination, respectively. 4 However, some rare neurological disorders post-COVID-19 vaccine, like Bell's palsy, encephalomyelitis, Guillain-Barré syndrome, and transverse myelitis have been reported. [5][6][7][8] Here, we report a case of new-onset acute encephalomyelitis after receiving the first dose of AZ vaccine.A 55-year-old man was admitted to hospital with fever and consciousness disturbance. The patient received the first dose of AZ vaccine 1 week before admission. Mild injection site pain was observed and subsided in the following 2 days. Two days before admission, the patient suffered from fever up to 39°C, nonproductive cough, general malaise and muscle soreness. One day before admission, progressive weakness and lowered consciousness and drowsiness developed. He had difficulty in sitting up from bed and changing clothes due to weakness. Due to progressive disorientation to people and place and slow response, he was referred to our hospital for help.

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Section: Discussionsupporting

confidence: 87%

“…Zuhorn et al 18 also reported 3 cases of acute encephalitis after AZ vaccine injection. We also summarize case reports of COVID‐19 vaccine‐related encephalomyelitis in Table 4 8,19–26 . Similar to our case, the symptoms of encephalitis developed within 30 days after vaccination.…”

Section: Discussionsupporting

confidence: 75%

Case report of acute encephalitis following the AstraZeneca COVID‐19 vaccine

Chen

Liu

et al. 2022

Int J of Rheum Dis

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“…Overall, we have identified 17 previous case reports of patients with ADEM following SARS-CoV-2 vaccination, including vaccines based on mRNA, viral vector and inactivated virus (Kania et al 2021 ; Vogrig et al 2021 ; Shimizu et al 2021 ; Lee et al 2022 ; Poli et al 2022 ; Ahmad et al 2022 ; Maramattom et al 2022 ; Rinaldi et al 2022 ; Permezel et al 2022 ; Mumoli et al 2022 ; Nagaratnam et al 2022 ; Al-Quliti et al 2022 ; Lazaro et al 2022 ; Garg et al 2022 ; Cao and Ren 2022 ; Ozgen Kenangil et al 2021 ; Yazdanpanah et al 2022 ); however, this case report is the first described case of ADEM following exposure to the Ad26.COV2.S vaccine.…”

Section: Discussionmentioning

confidence: 99%

“…We have been able to identify 17 case reports that have described ADEM, including one case report of ADEM-like presentation, following a COVID-19 vaccination: seven cases with mRNA vaccine (from Moderna and Pfizer), (Kania et al 2021 ; Vogrig et al 2021 ; Shimizu et al 2021 ; Lee et al 2022 ; Poli et al 2022 ; Ahmad et al 2022 ; Maramattom et al 2022 ) seven cases with a viral vector vaccine (from AstraZenica and Sputnik V) (Rinaldi et al 2022 ; Permezel et al 2022 ; Mumoli et al 2022 ; Nagaratnam et al 2022 ; Al-Quliti et al 2022 ; Lazaro et al 2022 ; Garg et al 2022 ) and three cases with vaccines based on inactivated virus (from SinoVac and Sinopharm) (Cao and Ren 2022 ; Ozgen Kenangil et al 2021 ; Yazdanpanah et al 2022 ). However, this case report is the first described case of ADEM following exposure to the Ad26.COV2.S vaccine from Johnson & Johnson.…”

Section: Introductionmentioning

confidence: 99%

Acute disseminated encephalomyelitis following the COVID-19 vaccine Ad26.COV2.S, a case report

2023

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Background The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has been leading to dramatic health, social and economic problems around the world. It was necessary to introduce worldwide vaccination program against SARS-CoV-2 virus. Vaccination of billions of people around the world leads to many questions about risk of vaccines and possible side effects. It is well known that acute disseminated encephalomyelitis (ADEM) is a rare, but possible complication of vaccines. Previously, cases of ADEM following various COVID-19 vaccines, including the vaccines from AstraZenica, Pfizer, Sputnik V, SinoVac, Moderna, Sinopharm, have been described. In this case report, we present the first documented case of ADEM following the COVID-19 vaccine Ad26.COV2.S from Johnson & Johnson. Case presentation We present the case of a 31-year-old female with gradually progression of right-sided weakness and numbness during a three-week period. Four weeks prior to symptom onset, the patient received the single-dose SARS-CoV-2 vaccine Ad26.COV2.S. Neuroimaging revealed five large juxtacortical T2 FLAIR hyperintense lesions with incomplete contrast enhancement on post-contrast T1 images located supratentorial: one in the right cerebral hemisphere and four in left cerebral hemisphere. The patient was followed up for four months. Symptom debut, clinical picture and MRI were typical for ADEM and the patient completely recovered after high dose intravenous methylprednisolone treatment. Conclusions This is, to the best of our knowledge, the first case report of ADEM following the COVID-19 vaccine Ad26.COV2.S. This case illustrates, although ADEM is a rare complication following SARS-CoV-2 vaccines, the necessity of maintaining a vaccine safety monitoring system to identify patients at high risk from developing severe complications from the vaccines.

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“…A review of the SARS-CoV-2 vaccine and ADEM literature showed 13 reported cases of ADEM following the administration of a COVID-19 vaccine, which are summarized in Table 2 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

Section: Discussionmentioning

confidence: 99%

Atypical acute disseminated encephalomyelitis with systemic inflammation after a first dose of AztraZaneca COVID-19 vaccine. A case report

et al. 2022

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BackgroundOnly a few cases of acute disseminated encephalomyelitis (ADEM) following coronavirus disease 19 (COVID-19) vaccination have been described since the beginning of the vaccination campaign.ResultsHere we report the first case of central nervous system (CNS) demyelination with systemic inflammatory findings on whole body 19-fluorodeoxyglucose positron emission tomography with computed tomography (FDG-PET/CT) following the ChAdOx1 nCoV-19 vaccine.ConclusionsClinicians should stay aware of potential new adverse events after immunization.

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Acute Demyelinating Encephalomyelitis Post-COVID-19 Vaccination: A Case Report and Literature Review

Cited by 17 publications

References 19 publications

Case report of acute encephalitis following the AstraZeneca COVID‐19 vaccine

Case report of acute encephalitis following the AstraZeneca COVID‐19 vaccine

Acute disseminated encephalomyelitis following the COVID-19 vaccine Ad26.COV2.S, a case report

Atypical acute disseminated encephalomyelitis with systemic inflammation after a first dose of AztraZaneca COVID-19 vaccine. A case report

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