Investigation of Neurological Complications after COVID-19 Vaccination: Report of the Clinical Scenarios and Review of the Literature

Chen, Weiping; Chen, Minghua; Shang, Shih-Ta; Kao, Yung‐Hsi; Wu, Kun; Chiang, Wei Fan; Chan, Jenq-Shyong; Shyu, Hann-Yeh; Hsiao, Po-Jen

doi:10.3390/vaccines11020425

Cited by 6 publications

(3 citation statements)

References 94 publications

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“…These cases suggest that COVID-19 vaccination might be associated with the development of NMOSD in certain individuals, particularly those with a history of autoimmune or demyelinating disorders. A rare case of vaccine-associated herpes simplex encephalitis was reported by Chen et al [ 61 ] in a patient who received the Pfizer-BioNTech vaccine. This finding highlights the importance of considering the potential for atypical neurological complications following COVID-19 vaccination and underscores the need for further research to better understand the possible underlying mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Post-COVID-19 Vaccination CNS Magnetic Resonance Imaging Findings: A Systematic Review

Ghaderi

Mohammadi

Heidari

et al. 2023

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Objective. This systematic review aims to synthesize and analyze the available literature on central nervous system (CNS) magnetic resonance imaging (MRI) findings in individuals who have received COVID-19 vaccinations. Our objective is to enhance understanding of potential neurological side effects, inform clinical practice, and guide future research on the neurological implications of COVID-19 vaccination. Methods. In this systematic review, we conducted a comprehensive search in PubMed, Scopus, and Web of Science from January 2020 to April 2023, using terms related to COVID-19 vaccination and CNS MRI findings. We evaluated the quality of the study, extracted relevant data, and included 89 eligible studies that covered various vaccines, demographics of patients, symptoms, and MRI findings to provide a thorough understanding of SARS-CoV-2 vaccination-related CNS problems. Results. We investigated CNS MRI findings following COVID-19 vaccination across various vaccine types. Common diseases associated with post-vaccination CNS MRI findings included cerebral venous sinus thrombosis (CVST), vaccine-induced immune thrombotic thrombocytopenia (VITT), acute disseminated encephalomyelitis (ADEM), acute myelitis, autoimmune encephalitis (AE), and others. Patients presented with diverse onset symptoms and neurological manifestations. Abnormalities identified in CNS MRI findings included white matter (WM) hyperintensity. Our analysis offers a comprehensive overview of the current literature on post-vaccination CNS MRI findings. Discussion. We highlight a range of post-COVID-19 vaccination CNS MRI findings, including CVST, with a higher incidence in individuals receiving the ChAdOx1 (AstraZeneca) vaccine. Other notable observations include cases of ADEM, myelitis or transverse myelitis (TM), Guillain–Barré syndrome (GBS), and acute encephalopathy following COVID-19 vaccination. The incidence of these neurological complications is extremely rare, and the benefits of vaccination outweigh the risks. The reviewed studies were primarily case reports or case series, and thus large-scale epidemiological studies and controlled clinical trials are needed to better understand the underlying mechanisms and risk factors associated with these neurological complications following COVID-19 vaccination.

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Section: Discussionmentioning

confidence: 99%

Post-COVID-19 Vaccination CNS Magnetic Resonance Imaging Findings: A Systematic Review

Ghaderi

Mohammadi

Heidari

et al. 2023

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…Sulaiman et al found that the use of thiamine as an adjunct therapy in critically ill patients with COVID-19 was associated with a lower incidence of thrombosis 364 . Chen et al successfully treated a patient with right facial weakness, after the second dose of the Moderna vaccine, with thiamine, riboflavin, and prednisolone 366 . Thus, postvaccination inflammatory mechanisms can thus also trigger neuropsychiatric symptoms via thiamine deficiency.…”

Section: Treatment Considerationsmentioning

confidence: 99%

COVID-19 vaccine adverse events: Evaluating the pathophysiology from an undersulfated and degraded glycocalyx perspective

Preez,

Lin,

Maguire

et al. 2023

Preprint

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In this literature review, we assess the pathophysiology of severe adverse events observed after vaccination with DNA and mRNA vaccines against COVID-19, despite reports of their overall effectiveness. The focus is on the perspective of an undersulfated and degraded glycocalyx, considering its impact on immunomodulation, inflammatory responses, coagulation, and oxidative stress. The paper explores various factors that lead to glutathione and inorganic sulfate depletion and their subsequent effect on glycocalyx sulfation and other metabolites, including hormones. Components of COVID-19 vaccines, such as DNA and mRNA material, spike protein antigen, and lipid nanoparticles, are involved in possible cytotoxic effects. The common thread connecting these adverse events is endotheliopathy or glycocalyx degradation caused by depleted glutathione and inorganic sulfate levels, shear stress from circulating nanoparticles, aggregation, and formation of protein coronas, leading to imbalanced immune responses and chronic release of pro-inflammatory cytokines, ultimately resulting in oxidative stress and systemic inflammatory response syndrome. By understanding the underlying pathophysiology of severe adverse events, better treatment options can be explored.

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“…Except COVID-19 infection, COVID-19 vaccinations have been reported to induce severe neurological adverse effects, such as ADEM, cerebrovascular stroke, cerebral venous sinus thrombosis and encephalitis [9][10][11][12]. However, the neuropathological mechanism of COVID-19-associated ADEM or ADEM after COVID-19 vaccinations is still not clear [4,13]. Similarly, the case presentation is a patient with SARS-CoV-2 infection presenting stroke-like manifestations, such as right hemiparesis, hemiparesthesia and dysarthria.…”

Section: Introductionmentioning

confidence: 99%

Comparison between SARS-CoV-2-Associated Acute Disseminated Encephalomyelitis and Acute Stroke: A Case Report

Jiang,

Chen,

Lin

et al. 2024

Reports

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The neurological manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are underrecognized. Ischemic stroke and thrombotic complications have been documented in patients with SARS-CoV-2 infection. Acute disseminated encephalomyelitis (ADEM) associated with coronavirus disease 2019 (COVID-19) is rare but can occur; the incidence of COVID-19-associated ADEM is still not clear due to the lack of reporting of cases. ADEM may have atypical stroke-like manifestations, such as hemiparesis, hemiparesthesia and dysarthria. The treatment strategies for ADEM and acute stroke are different. Early identification and prompt management may prevent further potentially life-threatening complications. We report a patient with SARS-CoV-2 infection presenting with stroke-like manifestations. We also make a comparison between demyelinating diseases, COVID-19-associated ADEM and acute stroke. This case can prompt physicians to learn about the clinical manifestations of SARS-CoV-2-associated ADEM.

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Investigation of Neurological Complications after COVID-19 Vaccination: Report of the Clinical Scenarios and Review of the Literature

Cited by 6 publications

References 94 publications

Post-COVID-19 Vaccination CNS Magnetic Resonance Imaging Findings: A Systematic Review

Post-COVID-19 Vaccination CNS Magnetic Resonance Imaging Findings: A Systematic Review

COVID-19 vaccine adverse events: Evaluating the pathophysiology from an undersulfated and degraded glycocalyx perspective

Comparison between SARS-CoV-2-Associated Acute Disseminated Encephalomyelitis and Acute Stroke: A Case Report

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