Post COVID-19 Vaccination Acute Disseminated Encephalomyelitis: A
Case Report

Garg, Amit; Batra, Parveen Kumar; Gupta, Pranav

doi:10.2174/1573405618666220509205457

Cited by 7 publications

(6 citation statements)

References 18 publications

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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%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

2023

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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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“…However, in 9442 AEFI reported in the Vaccine Adverse Event Reporting System (VAERS) of the Centers for Disease Control (CDC) 2.69% of cases presented with severe neurological manifestations 1 . A recent systematic review 2 analyzing the spectrum of such severe neurological complications differentiated between cerebral involvement, especially cerebrovascular events and inflammatory diseases 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 , spinal cord damage such as transverse myelitis 1 2 4 23 24 cranial and peripheral nerve involvement 2 4 25 and muscle affections, e. g. myositis 2 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Neurological key symptoms are headache, neuropsychological deficits, disorientation and dizziness 33 . ADEM associated with COVID-19 vaccination is rare and review of the literature currently yielded 22 cases with documented additional MR imaging abnormalities 2 3 4 5 6 7 8 9 10 11 13 14 16 18 19 20 21 22 . We report on another two cases of acute encephalitis and ADEM following COVID-19 vaccination.…”

Section: Introductionmentioning

confidence: 99%

Acute Disseminated Encephalomyelitis and Acute Encephalitis Following Vaccination Against SARS-CoV-2: Two Case Reports and Review of Literature

Weidauer

Zeitz

Tafreshi

et al. 2023

Fortschr Neurol Psychiatr

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The spectrum of severe neurological complications following COVID-19 vaccination includes cerebrovascular events, inflammatory diseases of the CNS, cranial and peripheral nerve involvement and muscle affections. Post-vaccinal acute disseminated encephalomyelitis (ADEM) and acute encephalitis are rare. We report on a patient suffering from acute encephalitis and another with post-vaccinal monophasic ADEM. Beside imaging features typical for acute autoimmune associated inflammation, cranial MRI disclosed also transient haemorrhagic signal alterations in some cerebral lesions. To our best knowledge, this has not been mentioned before in literature. Competing causes were excluded by extensive laboratory investigations including serial CSF analysis. In line with the literature, repeated iv high-dosage corticosteroid therapy resulted in impressive improvement of neurological symptoms in both patients.

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Post COVID-19 Vaccination Acute Disseminated Encephalomyelitis: A Case Report

Cited by 7 publications

References 18 publications

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

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

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

Acute Disseminated Encephalomyelitis and Acute Encephalitis Following Vaccination Against SARS-CoV-2: Two Case Reports and Review of Literature

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