Neurological autoimmune diseases following vaccinations against SARS-CoV-2

• Verfasst von: Kaulen, Leon D. [VerfasserIn]
• Verfasst von: Doubrovinskaia, Sofia [VerfasserIn]
• Verfasst von: Mooshage, Christoph [VerfasserIn]
• Verfasst von: Jordan, Berit [VerfasserIn]
• Verfasst von: Purrucker, Jan [VerfasserIn]
• Verfasst von: Haubner, Carmen [VerfasserIn]
• Verfasst von: Seliger, Corinna [VerfasserIn]
• Verfasst von: Lorenz, Hanns-Martin [VerfasserIn]
• Verfasst von: Nagel, Simon [VerfasserIn]
• Verfasst von: Wildemann, Brigitte [VerfasserIn]
• Verfasst von: Bendszus, Martin [VerfasserIn]
• Verfasst von: Wick, Wolfgang [VerfasserIn]
• Verfasst von: Schönenberger, Silvia [VerfasserIn]
• Titel: Neurological autoimmune diseases following vaccinations against SARS-CoV-2
• Titelzusatz: a case series
• Verf.angabe: 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, Silvia Schönenberger
• Jahr: 2022
• Umfang: 9 S.
• Fussnoten: First published: 19 October 2021 ; Gesehen am 09.01.2023
• Titel Quelle: Enthalten in: European journal of neurology
• Ort Quelle: Oxford [u.a.] : Wiley-Blackwell, 1994
• Jahr Quelle: 2022
• Band/Heft Quelle: 29(2022), 2, Seite 555-563
• ISSN Quelle: 1468-1331
• DOI: doi:10.1111/ene.15147
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: autoimmune
• Sach-SW: cerebral venous sinus thrombosis
• Sach-SW: COVID-19
• Sach-SW: Guillain-Barré syndrome
• Sach-SW: multiple sclerosis
• Sach-SW: myelitis
• Sach-SW: myositis
• K10plus-PPN: 1830574736
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

Background and purpose Population-based studies suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines may trigger immune-mediated thrombotic thrombocytopenia (VITT) raising concerns for other autoimmune responses. The aim was to characterize neurological autoimmunity after SARS-CoV-2 vaccinations. Methods In this single-centre prospective case study patients with neurological autoimmunity in temporal association (≤6 weeks) with SARS-CoV-2 vaccinations and without other triggers are reported. Clinical, laboratory and imaging data were collected with a median follow-up of 49 days. 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 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). Patients were predominantly female (ratio 3.2:1) and the median age at diagnosis was 50 years (range 22-86). Therapy included administration of steroids (n = 15), intravenous immunoglobulins in patients with Guillain-Barré syndrome or VITT (n = 4), plasma exchange in cases unresponsive to steroids (n = 3) and anticoagulation in VITT. Outcomes were favourable with partial and complete remissions achieved in 71% and 24%, respectively. Two patients received their second vaccination without further aggravation of autoimmune symptoms under low-dose immunosuppressants. Conclusions In this study various neurological autoimmune disorders encountered following SARS-CoV-2 vaccinations are characterized. Given the assumed low incidence and mostly favourable outcome of autoimmune responses, the benefits of vaccinations outweigh the comparatively small risks.