Clinical Manifestation, Management, and Outcomes in Patients with COVID-19 Vaccine-Induced Acute Encephalitis: Two Case Reports and a Literature Review

Shyu, Shiuan; Fan, Hua-Tung; Shang, Shih-Ta; Chan, Jenq-Shyong; Chiang, Wen-Fang; Chiu, Chih-Chien; Chen, Ming-Hua; Shyu, Hann-Yen; Hsiao, Po-Jen

doi:10.3390/vaccines10081230

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Clinical Manifestation, Management, and Outcomes in Patients with COVID-19 Vaccine-Induced Acute Encephalitis: Two Case Reports and a Literature Review

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Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan

Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan

Infectious Disease, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan

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Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan

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Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan

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Division of Neurology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan

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Department of Life Sciences, National Central University, Taoyuan 320, Taiwan

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Department of Medicine, Fu-Jen Catholic University Hospital, College of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan

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Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli County 350, Taiwan

Authors to whom correspondence should be addressed.

Academic Editor: Sung Ryul Shim

Vaccines 2022, 10(8), 1230; https://doi.org/10.3390/vaccines10081230

Received: 19 July 2022 / Revised: 29 July 2022 / Accepted: 29 July 2022 / Published: 31 July 2022

(This article belongs to the Special Issue Adverse Events of COVID-19 Vaccines)

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Abstract

Introduction: Vaccination is one of the best strategies to control coronavirus disease 2019 (COVID-19), and multiple vaccines have been introduced. A variety of neurological adverse effects have been noted after the implementation of large-scale vaccination programs. Methods: We reported two rare cases of possible mRNA-1273 vaccine-induced acute encephalitis, including clinical manifestations, laboratory characteristics, and management. Results: The clinical manifestations might be related to hyperproduction of systemic and cerebrospinal fluid (CSF) cytokines. mRNA vaccines are comprised of nucleoside-modified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA, which is translated into SARS-CoV-2 spike protein by the host’s ribosomes, activating the adaptive immune response. Exposed mRNA or vaccine components may also be detected as antigens, further resulting in aberrant proinflammatory cytokine cascades and activation of immune signaling pathways. Both patients exhibited significant clinical improvement after a course of steroid therapy. Conclusions: The use of COVID-19 vaccines to prevent and control SARS-CoV-2 infections and complications is the most practicable policy worldwide. However, inaccurate diagnosis or other diagnostic delays in cases of vaccine-induced acute encephalitis may have devastating and potentially life-threatening consequences for patients. Early diagnosis and timely treatment can result in a favorable prognosis. View Full-Text

Keywords: COVID-19 vaccine; mRNA-1273 vaccine; moderate; steroid; encephalitis

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Shyu, S.; Fan, H.-T.; Shang, S.-T.; Chan, J.-S.; Chiang, W.-F.; Chiu, C.-C.; Chen, M.-H.; Shyu, H.-Y.; Hsiao, P.-J. Clinical Manifestation, Management, and Outcomes in Patients with COVID-19 Vaccine-Induced Acute Encephalitis: Two Case Reports and a Literature Review. Vaccines 2022, 10, 1230. https://doi.org/10.3390/vaccines10081230

AMA Style

Shyu S, Fan H-T, Shang S-T, Chan J-S, Chiang W-F, Chiu C-C, Chen M-H, Shyu H-Y, Hsiao P-J. Clinical Manifestation, Management, and Outcomes in Patients with COVID-19 Vaccine-Induced Acute Encephalitis: Two Case Reports and a Literature Review. Vaccines. 2022; 10(8):1230. https://doi.org/10.3390/vaccines10081230

Chicago/Turabian Style

Shyu, Shiuan, Hua-Tung Fan, Shih-Ta Shang, Jenq-Shyong Chan, Wen-Fang Chiang, Chih-Chien Chiu, Ming-Hua Chen, Hann-Yen Shyu, and Po-Jen Hsiao. 2022. "Clinical Manifestation, Management, and Outcomes in Patients with COVID-19 Vaccine-Induced Acute Encephalitis: Two Case Reports and a Literature Review" Vaccines 10, no. 8: 1230. https://doi.org/10.3390/vaccines10081230

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Clinical Manifestation, Management, and Outcomes in Patients with COVID-19 Vaccine-Induced Acute Encephalitis: Two Case Reports and a Literature Review

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