The Potential Role of SARS-CoV-2 Infection and Vaccines in Multiple Sclerosis Onset and Reactivation: A Case Series and Literature Review
Abstract
:1. Introduction
2. MS Onset after SARS-CoV-2 Exposure
3. MS Relapses after COVID-19 Infection
4. MS Onset after Vaccine Exposure
5. MS Relapses after Vaccine Exposure
6. MS Diagnosis after COVID-19, with Probable Onset after SARS-CoV-2 Vaccines
7. Discussion
Authors | Vaccine Type/Dose | Time Interval | Symptoms | CE Lesions | Non-CE Lesions | OB | DMTs | §§ Anti-MOG/AQP4 Titration |
---|---|---|---|---|---|---|---|---|
MS ONSET | ||||||||
Case 6 | BNT/2nd | 2 weeks | Multisymptomatic (gait/trunk ataxia, sphincter) | (MRI not in acute phase) | + | + | -/- | |
Case 7 | ChAdOx1/1st | 1 week | SC | + | - | + | -/- | |
Case 11 | BNT/1st | 1 week | SC | SC | + | + | NA | |
Case 12 | BNT/1st | 2 weeks | SC | SC | + | + | +/+ | |
Lee et al. [51] * | Various | 0–55 days | Mainly SC | Various sites | variable | various | +/+ | |
Czarnowksa et al. [62] | JJ/1st | 2 weeks | SC | Brain, SC | + | + | +/+ | |
Havla et al. [95] | BNT/1st | 1 week | SC | SC | + | + | +/+ | |
Khayat-Khoei et al. [64] 3 cases | mRNA vaccines/ 2nd (2) | 2–3 weeks | ON (2) SC (1) | Brain (1) SC (2) | + | NA | -/+ | |
Kaulen et al. [65] | BNT (4) | 2 weeks | ON (4) SC (2) ST (2) | ON (4) SC (2) ST (2) | + | +/+ | ||
Mele et al. [66] | Mod/1st | 2 days | Cerebellum | ST | + | + | −/+ | |
Rinaldi et al. [68] 2 cases | BNT/1st (1) 2nd (1) | 1 week | BS+SC (1) ST (1) | BS+SC (1) ST+ SC non-ce (1) | + | + | +/+ | |
Gernert et al. [63] 5 cases | BNT (4, 3 cases 1st, 1 case 2nd), 1 ChadoOx/2nd | 1–2 weeks | ON (2) BS (1) SC (1) BS+SC (1) | SC (2) BS/cerebellum (3) | + | +/+ | ||
$ Watad et al. [69] 4 cases | BNT/1st (2) Mod/2nd (2) | 1 day–1 month | ST (1); cerebellum, SC (1) SC (2) | + | + | + | +/+ | |
$ Nistri et al. [67] 2 cases | ChadOx/1st | 1 week | ON (2) IT (1) | + supratentorial | + | + | -/- | |
Toljan et al. [70] 4 cases | BNT/1st (2) | Uncertain | + | + | + | -/- | ||
MS RELAPSE | ||||||||
Rinaldi et al. [68] | BNT/1st | 2 weeks | Cerebellum/BS | ST | + | + | IFNb | NA |
$ Al-Midfai et al. [71] | JJ/2nd | 2 weeks | Uncertain (unilateral motor deficit) | - | + | NA | - | NA |
$ Maniscalco et al. [72] | BNT/1st | 2 days | Unilateral SM deficit | ST | + | NA | FTY | NA |
Kataria et al. [73] | BNT/2nd | 3 weeks | ON + SC | ST | + | - | IFNß | NA |
Seyed Ahadi et al. [74] | Sinopharm/1st | 2 days | Paraparesis and ataxia | BS | + | NA | - | NA |
Kayat-Khoei et al. [64] 4 cases | mRNA vaccines 1st (1) and 2nd (3) | 1–3 weeks | ON (2) BS+SC (1) Possibly SC (1) | Brain (3) | + (new SC in 2 cases) | NA | NTZ (1) FTY (1) None (2) | NA |
$ Nistri et al. [67] 14 cases | ChadOx/1st (2) mRNA/1st (7), 2nd (5) | 2 days–3 weeks | BS/cerebellum (4) SC (6) Possibly SC (6) | Brain (13) | + | + | + (9) - (5) | NA |
D’apolito et al. [75] | BNT/2nd | 4 days | BS/cerebellum | + | - | + | FTY | NA |
$ Fragoso et al. [49] 8 cases | BNT/1st | BS | Various | Some | NA | NA | Various DMT (7) | NA |
8. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Authors | Time Interval | Anatomical Location Related to Clinical Symptoms | CE Lesions | Non-CE Lesions | OB | Previous Vaccine | §§ Anti-MOG/AQP4 Titration |
---|---|---|---|---|---|---|---|
MS ONSET | |||||||
Case 1 | 2 weeks | BS (dyplopia) | - | + | + | - | +/+ |
Moore et al. [52] | 2 weeks | BS (dyplopia) | BS, ST | + | + | NA | +/+ |
Yavari et al. [53] | 3 weeks | BS (dyplopia) | ST | + | NA | NA | -/- |
Carta et al. [54] | concomitant | BS (dyplopia) | ST ^ | + | NA | -/- | |
Pignolo et al. [55] 1st case | 8 weeks | BS (facial palsy) | - | + | + | - | +/+ |
Ismail et al. [76]. | 8 weeks | Cerebellum | - | + | + | - | -/- |
Case 2 | 2 weeks | ON | - SC | + | - | - | +/+ |
$ Case 3 | 2 weeks | ON | - | + | + | - | +/+ |
Palao et al. [56] | 2 weeks | ON | ST | + | + | - | +/+ |
Sarwar et al. [57] | 3 weeks | ON and unilateral motor deficit | ST | + | NA | NA | -/- |
Case 4 | 4 weeks | SC | SC | + | + | + | +/+ |
Fragoso et al. [58] | 6 months | SC | ST, SC | + | + | - | +/+ |
Avila et al. [59] * | 2–6 weeks | 40% SC 40% ON 20% BS | NA | NA | + | 80% - 20% + | NA/+ |
Feizi et al. [60] | 1 week | SC | SC | + | + | NA | +/+ |
MS RELAPSE | |||||||
Pignolo et al. [55] 2nd case | 2 months | Uncertain (unilateral motor symptoms) | ST | + | + | - | NA |
$ Case 5 | 3 weeks | Cerebellum (trunk/gait ataxia, dysmetria) | NA | NA | NA | + | NA |
Finsterer [61] | 2 weeks | SC (sensory symptoms both inferior limbs and trunk level) | SC | + | + | - | NA |
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Tavazzi, E.; Pichiecchio, A.; Colombo, E.; Rigoni, E.; Asteggiano, C.; Vegezzi, E.; Masi, F.; Greco, G.; Bastianello, S.; Bergamaschi, R. The Potential Role of SARS-CoV-2 Infection and Vaccines in Multiple Sclerosis Onset and Reactivation: A Case Series and Literature Review. Viruses 2023, 15, 1569. https://doi.org/10.3390/v15071569
Tavazzi E, Pichiecchio A, Colombo E, Rigoni E, Asteggiano C, Vegezzi E, Masi F, Greco G, Bastianello S, Bergamaschi R. The Potential Role of SARS-CoV-2 Infection and Vaccines in Multiple Sclerosis Onset and Reactivation: A Case Series and Literature Review. Viruses. 2023; 15(7):1569. https://doi.org/10.3390/v15071569
Chicago/Turabian StyleTavazzi, Eleonora, Anna Pichiecchio, Elena Colombo, Eleonora Rigoni, Carlo Asteggiano, Elisa Vegezzi, Francesco Masi, Giacomo Greco, Stefano Bastianello, and Roberto Bergamaschi. 2023. "The Potential Role of SARS-CoV-2 Infection and Vaccines in Multiple Sclerosis Onset and Reactivation: A Case Series and Literature Review" Viruses 15, no. 7: 1569. https://doi.org/10.3390/v15071569