Acute Transverse Myelitis after COVID-19 Vaccination

Abstract

The adverse effects of the COVID-19 vaccine have been discovered as the rapid application of the vaccines continues. Neurological complications such as transverse myelitis raise concerns as cases were observed in clinical trials. Transverse myelitis is a rare immune-mediated disease with spinal cord neural injury, resulting in neurological deficits in the motor, sensory, and autonomic system. Vaccine-related transverse myelitis is even rarer. We present a case of acute transverse myelitis after vaccination against COVID-19 with the ChAdOx1 nCOV-19 vaccine (AZD1222), which was the first case reported in Taiwan. Although it rarely occurs, post-vaccination neurological complications should not be ignored. As the pandemic of SARS-COV-2 continues to spread and concern about vaccination efficacy and safety rises, heterologous vaccination were implemented in health public policy in several countries. A literature review of several clinical trials shows promising effects of mix-and-match vaccination. Further study on different combinations of vaccines can be expected.

A systematic review of cases of CNS demyelination following COVID-19 vaccination

“… PLEX Marked improvement. 15- Hsiao et al ( Hsiao et al, 2021 ) 41/M DM Negative nasopharyngeal swab for SARS-CoV-2-RT-PCR. ChAdOx1 nCOV-19 vaccine (AZD1222) Viral vector 1st 7 days TM (LETM) Tingling sensation over T4 dermatome, followed by progressive paresthesia below T4, along with lower-limb weakness and clumsiness Normal: CBC, metabolic profile.…”

Adverse drug reactions from two COVID-19 vaccines reported in Saudi Arabia

“…However, the researchers in this study revealed that mild neurological-related ADRs were also commonly reported. The mechanisms responsible for these neurological issues associated with COVID-19 vaccines are not well understood, but some studies hypothesized that elevated blood levels of specific types of inflammatory cytokines could be correlated with intensive immune responses, causing some damage to the neurons [ 15 , 16 ].…”

Acute transverse myelitis after BNT162b2 vaccination against COVID-19: Report of a fatal case and review of the literature

“…However, several vaccination-related neurological complications have been reported ( 2 ). There was an unexpectedly high incidence of acute transverse myelitis (ATM) as a neurological complication following COVID-19 infection (approximately 1.2–3.2%) ( 3 , 4 ), and 11 cases of ATM after inoculation of several types of COVID-19 vaccines had been reported by October 7, 2021 ( [5] , [6] , [7] ). Herein, we describe a case of ATM with a fatal prognosis following vaccination with an mRNA-based COVID-19 vaccine (BNT162b2, Pfizer) and review the clinical features of ATM in COVID-19 vaccine recipients.…”

“…An increasing number of people are having the opportunity to get access to COVID-19 vaccines, and several neurological manifestations have been reported in COVID-19 vaccine recipients ( 2 ). Among the cases of severe neurological complications following COVID-19 vaccination, 11 of ATM had been reported by October 7, 2021 ( [5] , [6] , [7] ). We have shown the clinical features of ATM after COVID-19 vaccination ( Table 1 ).…”