Fatal Multiple Sclerosis After COVID-19 Vaccination and Infection

Multiple sclerosis (MS) is a chronic autoimmune disorder that affects the central nervous system, leading to a wide range of neurological symptoms. 
While this disease is most commonly diagnosed in individuals in their 20s and 30s, it is rare for MS to result in sudden death in younger patients. 

A 19-year-old male soldier received the second dose of the COVID-19 vaccine (Pfizer-BioNTech). 3 months later, he started experiencing epileptic seizures during sleep and was admitted to an outside hospital. Since the first seizure, he presented with 5 more generalized tonic-clonic seizures within a week. He had no other symptoms or signs of meningeal irritation. Cerebrospinal fluid (CSF) analysis including culture and viral polymerase chain reaction revealed no abnormalities except for mild pleocytosis. Oligoclonal band and aquaporin-4 antibodies were not detected in the CSF and serum. Brain MRI performed 1 day after the seizure revealed T2 hyperintensities in the periventricular region, subcortical white matter, and left basal ganglia, raising a suspicion of demyelinating disorder, and leptomeningeal enhancement of cerebral convexities. Additional brain MRI performed 8 days after the first seizure was suggestive of cerebral venous thrombosis (CVT) due to intracranial hypotension. 

He was treated with empirical antiviral/antibiotic medications, anticonvulsant and anticoagulant for 3 weeks and was discharged after symptom improvement. Seizures seemed to be controlled with medication management. Two months later he developed a sore throat without fever and tested positive for COVID-19. 10 days later, he returned to duty. He had been suffering from left finger numbness at night and because of this asked his commander for exemption from night duty. A little over a week since returning to work, said to his colleague “I cannot sleep well these days and I feel like I'm having a seizure at night.” Next morning, he was found dead in bed in supine position, with his head slightly turned to the right and his right arm raised. 

Based on autopsy, histologic, and toxicological findings and medical records, the cause of death was determined to be MS with suspected exacerbation. 



REFERENCE

Jeon YH, Choi S, Park JH, Lee JK, Yeo NS, Lee S, Suh YL. Sudden Death Associated With Possible Flare-Ups of Multiple Sclerosis After COVID-19 Vaccination and Infection: A Case Report and Literature Review. J Korean Med Sci. 2023 Mar 13;38(10):e78. doi: 10.3346/jkms.2023.38.e78. PMID: 36918031; PMCID: PMC10010908.

Comments

Post a Comment

Popular posts from this blog

A New Onset of Ulcerative Colitis post-2nd-breakthrough-COVID-19

Image
A 21-year-old non-smoking Caucasian male with a history of acute pancreatitis but no other medical issues or family history had two doses of the BNT162b2 mRNA COVID-19 vaccine.  Four months after the second dose he had his first episode of COVID-19. Although not hypoxic, he felt pretty unwell for a week, with a severe cough, fever, generalized body ache, headache, and loss of taste. He received the third dose of the vaccine two months after recovering from COVID. Nine months after the third dose, he had the second episode of COVID-19, during which he was mildly unwell for three days, recovered, and did not require any anti-viral medication or antibiotics. One week post the second episode of COVID-19, he developed diarrhea and abdominal pain. It then progressed to bloody diarrhea. Ulcerative colitis was diagnosed based on his clinical symptoms, biopsy changes, and the exclusion of other causes.  There are ten published case reports about the newly diagnosed ulcerative colitis associate
Read more

COVID in May

Image
Concerns about a potential resurgence of COVID-19 are mounting as summer 2024 approaches.  This is driven by several indicators, including social media posts, healthcare data, and wastewater surveillance across different regions. Our study findings corroborate this trend.  While many forecasters anticipate a surge, others expect a gradual increase through the end of May, and then a decline again around early June. Reports from social media suggest emerging clusters of COVID-19 in Texas, several Canadian provinces, the UK, and on cruises in northern regions such as a Norwegian cruise to Alaska.  Data from Alberta's Respiratory virus dashboard   (total weekly laboratory-confirmed COVID-19 cases) and wastewater surveillance in Calgary indicate an uptick in COVID-19 cases starting April 2024. The most recent statistics from Alberta Health reveal a significant increase in hospitalizations due to COVID-19, with 114 individuals currently hospitalized—an increase of more than 20% over two
Read more

Chronic SARS-CoV-2 Shedding

Image
Chronic viral shedding, a condition where the virus continues to be released from an individual's body long after the initial infection, has been observed in many infectious diseases, including COVID-19.  In such cases, individuals may remain asymptomatic or experience only mild symptoms while the virus persists. It remains detectable in repeated tests over an extended period and can still infect others even in nasal swab is negative (which happens quite often ). This was evident in our study.    Recent research by Conway et al. (2024) highlights the possibility of chronic SARS-CoV-2 infection, extending over several months and potentially years. Other studies have documented prolonged asymptomatic infections and extended viral shedding in moderate to severe beyond hospital discharge. Analysis of sequencing data on UK samples taken between 2 November 2020 and 15 August 2022 lead to estimates that 0.1–0.5% of infections may become persistent with typically rebounding high viral load
Read more