Weirauch Tobias, Schüttfort Gundolf, Vehreschild Maria J G T
Goethe University Frankfurt, University Hospital Frankfurt, Department II of Internal Medicine, Infectious Diseases, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
Infection. 2025 Apr;53(2):741-746. doi: 10.1007/s15010-024-02439-y. Epub 2024 Dec 2.
mRNA-based vaccines played a key role in fighting the global COVID-19 pandemic by saving millions of lives. In rare cases, however, the BNT162b2 vaccine has been associated with severe adverse reactions e.g. myocarditis (OE ratio 2.78; 95% CI 2.61; 2.95) [Faksova in Vaccine 42(9):2200-2211, 2024, https://doi.org/10.1016/j.vaccine.2024.01.100 , Schwab in Clin Res Cardiol 112(3):431-440, 2022, https://doi.org/10.1007/s00392-022-02129-5 ]. Here, we describe the case of a 38-year-old man who developed a wide variety of long-term symptoms (fatigue, dizziness, palpitations with recurrent syncopes, paresthesia, paresis and fasciculations) following his first mRNA-based BNT162b2 COVID-19 vaccination. 143 days after vaccination, a subsequent COVID-19 infection was associated with exacerbation of paresis and a temporary loss of vision. After ruling out other causes and due to the immediate temporal association, an adverse reaction to vaccination appears likely. The fact that these symptoms worsened after a subsequent acute COVID 19 infection hints at the possibility of a common underlying pathophysiology. This case combines two clinical phenomena that have emerged during the COVID 19 pandemic, side effects associated with novel vaccines and Post-COVID Syndrome.
基于信使核糖核酸的疫苗通过拯救数百万人的生命，在抗击全球新冠疫情中发挥了关键作用。然而，在罕见情况下，BNT162b2疫苗与严重不良反应有关，例如心肌炎（优势比2.78；95%置信区间2.61；2.95）[法克索娃，《疫苗》42(9):2200 - 2211，2024，https://doi.org/10.1016/j.vaccine.2024.01.100 ；施瓦布，《临床研究心脏病学》112(3):431 - 440，2022，https://doi.org/10.1007/s00392-022-02129-5 ]。在此，我们描述了一名38岁男性的病例，他在首次接种基于信使核糖核酸的BNT162b2新冠疫苗后出现了多种长期症状（疲劳、头晕、心悸伴反复晕厥、感觉异常、轻瘫和肌束震颤）。接种疫苗143天后，随后的新冠病毒感染与轻瘫加重和暂时失明有关。在排除其他原因后，由于时间上的直接关联，疫苗不良反应似乎很可能发生。这些症状在随后的急性新冠病毒感染后恶化，这一事实暗示了可能存在共同的潜在病理生理学机制。该病例结合了新冠疫情期间出现的两种临床现象，即新型疫苗的副作用和新冠后综合征。
