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

Bastide, Laure; Perrotta, Gaetano; Lolli, Valentina; Mathey, Céline; Vierasu, Ortensa-Irina; Goldman, Serge; Vandergheynst, Frédéric

doi:10.3389/fneur.2022.995875

Cited by 6 publications

(2 citation statements)

References 28 publications

(29 reference statements)

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“…A systematic review has been identified (8) including 20 studies, out of which 19 were eligible to be included in our review: (9,10,(19)(20)(21)(22)(23)(24)(25)(26)(27)(11)(12)(13)(14)(15)(16)(17)(18) (Figure 1) In addition to the 19 studies included, our literature search has identified nine other studies: (28)(29)(30)(31)(32)(33)(34)(35). Thus, a total of 28 studies were analysed comprising a total of 38 cases.…”

Section: Resultsmentioning

confidence: 99%

The Heart vs. Brain, are They Also Different when it Comes to Post Vaccination Complications, Insights from a Systematic Review of Post-COVID-19 ADEM and Myopericarditis Cases

AbdelMassih¹,

Kamel²,

Mohammad³

et al. 2023

Preprint

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Background: COVID-19 vaccines have been a game changer in the pandemic, their extensive use was favorable compared to the burden of COVID-19 complications. Despite the low incidence of complications, it was important to analyze them carefully to understand the underlying mechanisms and predisposing factors. For instance, myopericarditis especially from mRNA vaccines, and its relatively higher prevalence in young adults and adolescents has raised a public concern about the use of this vaccine in this group. We aimed through this review to compare the age likelihood of ADEM from COVID-19 vaccines, with that reported in myopericarditis cases; secondary outcome parameters included the gender and number of doses needed to induce COVID-19 vaccines related ADEM. Methodology: A literature search has been conducted on relevant databases to retrieve all case reports/series and systematic reviews describing ADEM with possible linkage to COVID-19. Exclusion criteria included any report not including the desired outcome parameters. Our results were then qualitatively compared with a similar systematic review reporting myopericarditis from COVID-19 vaccines. Results: In 38 cases with ADEM, mean age was 49±16 compared to 25±14 in myopericarditis, females were more likely to be affected, and while most of myopericarditis cases develop after the second dose, most of ADEM cases develop after the first dose (76%). Moreover, age>56 years was more predictive of negative outcome after ADEM in the form of death or permanent vegetative state. Conclusion: The discrepancy in age, gender and number of doses needed to induce complications between ADEM and myopericarditis, signify that the tissue affected is the major orchestrator of the age, gender, and dose characteristics, and not the type of vaccines. A leakier blood brain barrier with aging, might allow easier passage of autoantibodies and cytokines into the brain while lack of inhibitory immune checkpoints in the myocardium in young age might explain the higher prevalence of those cases in young adults and adolescents.

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Section: Resultsmentioning

confidence: 99%

The Heart vs. Brain, are They Also Different when it Comes to Post Vaccination Complications, Insights from a Systematic Review of Post-COVID-19 ADEM and Myopericarditis Cases

AbdelMassih¹,

Kamel²,

Mohammad³

et al. 2023

Preprint

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“…The key therapy for severe patients includes IVIG, steroids, and plasma exchange [ 100 ]. ADEM usually presents as a monophasic course, although a few recurrent cases have been reported [ 104 ]. Fortunately, most patients have a good prognosis after treatment, with a few fatal cases [ 102 ].…”

Section: Discussionmentioning

confidence: 99%

Neurological Disorders following COVID-19 Vaccination

Yang

Huang

2023

Vaccines

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Nowadays, people all over the world have been receiving different types of coronavirus disease 2019 (COVID-19) vaccines. While their effectiveness has been well recognized, various post-vaccination disorders are not fully understood. In this review, we discuss neurological disorders related to vascular, immune, infectious, and functional factors following COVID-19 vaccination, and attempt to provide neuroscientists, psychiatrists, and vaccination staff with a reference for the diagnosis and treatment of these diseases. These disorders may present as a recurrence of previous neurological disorders or new-onset diseases. Their incidence rate, host and vaccine characteristics, clinical manifestations, treatment, and prognosis differ significantly. The pathogenesis of many of them remains unclear, and further studies are needed to provide more evidence. The incidence rate of severe neurological disorders is relatively low, most of which are reversible or treatable. Therefore, the benefits of vaccination outweigh the risk of COVID-19 infection, especially among fragile populations.

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Azd-1222

2022

Reactions Weekly

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

Cited by 6 publications

References 28 publications

The Heart vs. Brain, are They Also Different when it Comes to Post Vaccination Complications, Insights from a Systematic Review of Post-COVID-19 ADEM and Myopericarditis Cases

The Heart vs. Brain, are They Also Different when it Comes to Post Vaccination Complications, Insights from a Systematic Review of Post-COVID-19 ADEM and Myopericarditis Cases

Neurological Disorders following COVID-19 Vaccination

Azd-1222

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