Nistri Riccardo, Barbuti Elena, Rinaldi Virginia, Tufano Laura, Pozzilli Valeria, Ianniello Antonio, Marinelli Fabiana, De Luca Giovanna, Prosperini Luca, Tomassini Valentina, Pozzilli Carlo
Neurology Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
Institute of Advanced Biomedical Technologies (ITAB), Department of Neurosciences, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
Front Neurol. 2021 Oct 22;12:765954. doi: 10.3389/fneur.2021.765954. eCollection 2021.
To describe a temporal association between COVID-19 vaccine administration and multiple sclerosis (MS) relapses. This case series study was collected in four MS Centres in Central Italy, using data from 16 MS patients who received COVID-19 vaccination and presented both clinically and radiologically confirmed relapses between March and June 2021. We collected patients' relevant medical history, including demographics, MS clinical course, disease-modifying treatment (DMT) received (if applicable), and data from MRI scans obtained after the COVID-19 vaccination. Three out of 16 patients received a diagnosis of MS with a first episode occurring after COVID-19 vaccination; 13 had already a diagnosis of MS and, among them, 9 were on treatment with DMTs. Ten patients received BNT162b2/Pfizer-BioNTech, 2 patients mRNA-1273/Moderna, and 4 patients ChAdOx1 nCoV-19/AstraZeneca. All MS relapses occurred from 3 days to 3 weeks after receiving the first dose of the COVID-19 vaccination or the booster. All patients had evidence of radiological activity on MRI. Clinical and radiological findings in these cohort of MS patients confirmed disease re/activation and suggested a temporal association between disease activity and COVID-19 vaccination. The nature of this temporal association, whether causative or incidental, remains to be established.
描述新型冠状病毒肺炎（COVID-19）疫苗接种与多发性硬化症（MS）复发之间的时间关联。本病例系列研究收集了意大利中部四个MS中心的数据，来自16例接受COVID-19疫苗接种且在2021年3月至6月期间出现临床和影像学确诊复发的MS患者。我们收集了患者的相关病史，包括人口统计学资料、MS临床病程、接受的疾病修正治疗（DMT）（如适用）以及COVID-19疫苗接种后获得的MRI扫描数据。16例患者中有3例在COVID-19疫苗接种后首次发作被诊断为MS；13例已有MS诊断，其中9例正在接受DMT治疗。10例患者接种了BNT162b2/辉瑞-BioNTech疫苗，2例接种了mRNA-1273/Moderna疫苗，4例接种了ChAdOx1 nCoV-19/阿斯利康疫苗。所有MS复发均发生在接种第一剂COVID-19疫苗或加强针后3天至3周内。所有患者MRI检查均有影像学活动证据。这些MS患者队列的临床和影像学结果证实了疾病的重新/激活，并提示疾病活动与COVID-19疫苗接种之间存在时间关联。这种时间关联的性质，无论是因果关系还是偶然关系，仍有待确定。
