The Potential Role of SARS-CoV-2 Infection and Vaccines in Multiple Sclerosis Onset and Reactivation: A Case Series and Literature Review

Pichiecchio, Anna; Colombo, E; Rigoni, Eleonora; Asteggiano, Carlo; Vegezzi, Elisa; Masi, Francesco Di; Greco, Giacomo; Bastianello, Stefano; Bergamaschi, Roberto

doi:10.3390/v15071569

Cited by 5 publications

(2 citation statements)

References 97 publications

(141 reference statements)

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“…Multiple sclerosis (MS) is a chronic, inflammatory, autoimmune disease for the central nervous system (CNS) characterized by the dissemination of demyelinating plaques in time and space, with pathophysiological pathways that include balance impairments caused by cerebellar, vestibular, or deep sensory dysfunction (29). The pathogenesis of MS was still uncertain, but genetic alterations, obesity, smoking, and especially, EBV infection have been implicated as etiologic factor (30, 31), which reinforced the hypothesis that viral vaccines could act as triggers for immune abnormalities leading to inflammatory demyelinating CNS disorders ultimately (32).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 vaccination and the risk of autoimmune diseases: a Mendelian randomization study

Shan,

Hu,

Chen

et al. 2024

Front. Public Health

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BackgroundIn recent times, reports have emerged suggesting that a variety of autoimmune disorders may arise after the coronavirus disease 2019 (COVID-19) vaccination. However, causality and underlying mechanisms remain unclear.MethodsWe collected summary statistics of COVID-19 vaccination and 31 autoimmune diseases from genome-wide association studies (GWAS) as exposure and outcome, respectively. Random-effects inverse variance weighting (IVW), MR Egger, weighted median, simple mode, and weighted mode were used as analytical methods through Mendelian randomization (MR), and heterogeneity and sensitivity analysis were performed.ResultsWe selected 72 instrumental variables for exposure (p < 5 × 10−6; r2 < 0.001, genetic distance = 10,000 kb), and MR analyses showed that COVID-19 vaccination was causally associated with an increased risk of multiple sclerosis (MS) (IVW, OR: 1.53, 95% CI: 1.065–2.197, p = 0.026) and ulcerative colitis (UC) (IVW, OR: 1.00, 95% CI: 1.000–1.003, p = 0.039). If exposure was refined (p < 5 × 10−8; r2 < 0.001, genetic distance = 10,000 kb), the associations became negative. No causality was found for the remaining outcomes. These results were robust to sensitivity and heterogeneity analyses.ConclusionOur study provided potential evidence for the impact of COVID-19 vaccination on the risk of MS and UC occurrence, but it lacks sufficient robustness, which could provide a new idea for public health policy.

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Section: Discussionmentioning

confidence: 99%

COVID-19 vaccination and the risk of autoimmune diseases: a Mendelian randomization study

Shan,

Hu,

Chen

et al. 2024

Front. Public Health

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“…The association between COVID-19 vaccination and MS onset is still debated in the literature [57,58]. Havla and Coll.…”

Section: Discussionmentioning

confidence: 99%

Multiple Sclerosis Onset before and after COVID-19 Vaccination: Can HLA Haplotype Be Determinant?

Bianco,

Di Sante,

Colò

et al. 2024

IJMS

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A few cases of multiple sclerosis (MS) onset after COVID-19 vaccination have been reported, although the evidence is insufficient to establish causality. The aim of this study is to compare cases of newly diagnosed relapsing–remitting MS before and after the outbreak of the COVID-19 pandemic and the impact of COVID-19 vaccination. Potential environmental and genetic predisposing factors were also investigated, as well as clinical patterns. This is a single-centre retrospective cohort study including all patients who presented with relapsing–remitting MS onset between January 2018 and July 2022. Data on COVID-19 vaccination administration, dose, and type were collected. HLA-DRB1 genotyping was performed in three subgroups. A total of 266 patients received a new diagnosis of relapsing–remitting MS in our centre, 143 before the COVID-19 pandemic (until and including March 2020), and 123 during the COVID-19 era (from April 2020). The mean number of new MS onset cases per year was not different before and during the COVID-19 era and neither were baseline patients’ characteristics, type of onset, clinical recovery, or radiological patterns. Fourteen (11.4%) patients who subsequently received a new diagnosis of MS had a history of COVID-19 vaccination within one month before symptoms onset. Patients’ characteristics, type of onset, clinical recovery, and radiological patterns did not differ from those of patients with non-vaccine-related new diagnoses of MS. The allele frequencies of HLA-DRB1*15 were 17.6% and 22.2% in patients with non-vaccine-related disease onset before and during the COVID-19 era, respectively, while no case of HLA-DRB1*15 was identified among patients with a new diagnosis of MS post-COVID-19 vaccine. In contrast, HLA-DRB1*08+ or HLA-DRB1*10+ MS patients were present only in this subgroup. Although a causal link between COVID-19 vaccination and relapsing–remitting MS cannot be detected, it is interesting to note and speculate about the peculiarities and heterogeneities underlying disease mechanisms of MS, where the interactions of genetics and the environment could be crucial also for the follow-up and the evaluation of therapeutic options.

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AZD-1222/tozinameran

2023

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The Potential Role of SARS-CoV-2 Infection and Vaccines in Multiple Sclerosis Onset and Reactivation: A Case Series and Literature Review

Cited by 5 publications

References 97 publications

COVID-19 vaccination and the risk of autoimmune diseases: a Mendelian randomization study

COVID-19 vaccination and the risk of autoimmune diseases: a Mendelian randomization study

Multiple Sclerosis Onset before and after COVID-19 Vaccination: Can HLA Haplotype Be Determinant?

AZD-1222/tozinameran

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