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Central nervous system immune-related disorders after SARS-CoV-2 vaccination: a multicenter study

Vogrig, Alberto ; Tartaglia, Sara ; Dentoni, Marta ; Fabris, Martina ; Bax, Francesco ; Belluzzo, Marco ; Verriello, Lorenzo ; Bagatto, Daniele ; Gastaldi, Matteo ; Tocco, Pierluigi ; Zoccarato, Marco ; Zuliani, Luigi ; Pilotto, Andrea ; Padovani, Alessandro ; Villagrán-García, Macarena ; Davy, Vincent ; Gigli, Gian Luigi ; Honnorat, Jérôme ; Valente, Mariarosaria

Frontiers in immunology, 2024-02, Vol.15, p.1344184-1344184 [Periódico revisado por pares]

Switzerland: Frontiers Media S.A

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Título:
Central nervous system immune-related disorders after SARS-CoV-2 vaccination: a multicenter study
Autor: Vogrig, Alberto ; Tartaglia, Sara ; Dentoni, Marta ; Fabris, Martina ; Bax, Francesco ; Belluzzo, Marco ; Verriello, Lorenzo ; Bagatto, Daniele ; Gastaldi, Matteo ; Tocco, Pierluigi ; Zoccarato, Marco ; Zuliani, Luigi ; Pilotto, Andrea ; Padovani, Alessandro ; Villagrán-García, Macarena ; Davy, Vincent ; Gigli, Gian Luigi ; Honnorat, Jérôme ; Valente, Mariarosaria
Assuntos: Central Nervous System ; Cohort Studies ; COVID-19 ; COVID-19 - prevention & control ; COVID-19 Vaccines - adverse effects ; Encephalomyelitis, Acute Disseminated - etiology ; Humans ; Immunology ; Myelitis ; neurologic adverse events ; neurological complications ; Neuromyelitis Optica - therapy ; Retrospective Studies ; SARS-CoV-2 ; vaccination ; Vaccination - adverse effects ; vaccine
É parte de: Frontiers in immunology, 2024-02, Vol.15, p.1344184-1344184
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
These authors share senior authorship
Federico Verde, Italian Auxological Institute (IRCCS), Italy
Federico Massa, University of Genoa, Italy
Edited by: Samir Abu Rumeileh, Martin Luther University of Halle-Wittenberg, Germany
Reviewed by: Matteo Foschi, Azienda Unità Sanitaria Locale (AUSL) della Romagna, Italy
Descrição: COVID-19 vaccines have been approved due to their excellent safety and efficacy data and their use has also permitted to reduce neurological complications of SARS-CoV-2. However, clinical trials were underpowered to detect rare adverse events. Herein, the aim was to characterize the clinical spectrum and immunological features of central nervous system (CNS) immune-related events following SARS-CoV-2 vaccination. Multicenter, retrospective, cohort study (December 1, 2020-April 30, 2022). Inclusion criteria were (1) CNS disorders developing after SARS-CoV-2 vaccination (probable causal relationship as per 2021 Butler criteria) (2); evidence for an immune-mediated etiology, as per (i) 2016 Graus criteria for autoimmune encephalitis (AE); (ii) 2015 Wingerchuk criteria for neuromyelitis optica spectrum disorders; (iii) criteria for myelitis. Nineteen patients were included from 7 tertiary referral hospitals across Italy and France (one of them being a national referral center for AE), over almost 1 year and half of vaccination campaign. Vaccines administered were mRNA-based (63%) and adenovirus-vectored (37%). The median time between vaccination and symptoms onset was 14 days (range: 2-41 days). CSF was inflammatory in 74%; autoantibodies were detected in 5%. CSF cytokine analysis (n=3) revealed increased CXCL-10 (IP-10), suggesting robust T-cell activation. The patients had AE (58%), myelitis (21%), acute disseminated encephalomyelitis (ADEM) (16%), and brainstem encephalitis (5%). All patients but 2 received immunomodulatory treatment. At last follow-up (median 130 days; range: 32-540), only one patient (5%) had a mRS>2. CNS adverse events of COVID-19 vaccination appear to be very rare even at reference centers and consist mostly of antibody-negative AE, myelitis, and ADEM developing approximately 2 weeks after vaccination. Most patients improve following immunomodulatory treatment.
Editor: Switzerland: Frontiers Media S.A
Idioma: Inglês

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Central nervous system immune-related disorders after SARS-CoV-2 vaccination: a multicenter study

Switzerland: Frontiers Media S.A

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