Index Entries

Leon D. Kaulen, Sofia Doubrovinskaia, Christoph Mooshage, Berit Jordan, Jan Purrucker, Carmen Haubner, Corinna Seliger, Hanns-Martin Lorenz, Simon Nagel, Brigitte Wildemann, Martin Bendszus, Wolfgang Wick, and Silvia Schönenberger
January 11, 2022
European Journal of Neurology
Heidelberg University (Germany)

"Abstract

Results: In the study period 232,603 inhabitants from the main catchment area of our hospital (Rhein-Neckar-Kreis, county) received SARS-CoV-2 vaccinations. Twenty-one cases (new onset n=17, flares n=4) diagnosed a median of 11 days (range 3–23) following SARS-CoV-2 vaccinations (BNT162b2 n=12, ChAdOx1 n=8, mRNA-1273 n=1) were identified. Cases included VITT [vaccine-induced thrombotic thrombotocytopenia] with cerebral venous sinus thrombosis (n=3), central nervous system demyelinating diseases (n=8), inflammatory peripheral neuropathies (n=4), myositis (n=3), myasthenia (n=1), limbic encephalitis (n=1) and giant cell arteritis (n=1)... 

Introduction

... Recent reports suggest that several SARS-CoV-2 vaccines may induce platelet factor 4 (PF4) antibody-mediated thrombotic thrombocytopenia (VITT) 5–30 days following vaccination. Similarly, cases of facial palsy, Guillain–Barré syndrome (GBS) and transverse myelitis have been documented following SARS-CoV-2 vaccinations. It remains unclear whether COVID-19 vaccines trigger additional neurological autoimmune responses, particularly in patients with pre-existing autoimmunity. In this single-centre case study, the longitudinal characteristics of 21 patients with various neurological autoimmune reactions in the temporal context of SARS-CoV-2 vaccinations are defined...

Discussion

Recent population-based studies found a significantly increased risk for PF4-antibody-mediated VITT with subsequent CVST [cerebral venous sinus thrombosis] following ChAdOx1 vaccinations. Similarly, analysing the vaccine adverse events reporting database the US Food and Drug Administration noted a potential association between Ad26.COV2.S vaccinations and GBS and revised the vaccine fact sheet accordingly. Although the subject of ongoing research [sic], these findings suggest that SARS-CoV-2 vaccinations may trigger neurological autoimmune responses in rare cases with pathomechanisms and risk factors warranting further investigation."

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adverse events,autoimmunity,COVID-19,neurological disorders,vaccines