COVID-19 Infection, Vaccination May Unmask Underlying Neuroinflammatory Conditions

A case study presented at the 2022 CMSC Annual Meeting reviews a 47-year-old male patient who experienced relapsing steroid-responsive encephalomyelitis after SARS-CoV-2 infection and subsequent COVID-19 infection.

Vaccines containing SARS-CoV-2 antigens may lead to enhanced autoimmunity resulting in insidious and extensive inflammation, according to a case study presented at the 2022 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC), held from June 1-4, 2022 in National Harbor, Maryland.

The patient was a 47-year-old male with a patient history of psoriasis and COVID-19. Patient received his COVID-19 vaccination 3 months after recovering from COVID-19 infection and presented with subacute lower extremity weakness, erectile dysfunction, and gait instability with falls several weeks after vaccination.

Magnetic resonance imaging revealed enhancing lesions involving the cerebellum, brainstorm, basal ganglia, and spinal cord parenchyma. Cerebrospinal fluid testing revealed a lymphocytic pleocytosis, transient matched serum, and cerebrospinal fluid oligoclonal bands. There were no other remarkable laboratory results.

The patient improved significantly after a 5-day treatment of high-dose methylprednisolone. Pulse of intravenous steroids were needed when transitioning to oral prednisone due to a recurrence of symptoms on day 6 and after 2 months of chronic treatment with steroids.

Previous case studies have identified 20 additional cases of central nervous system neuroinflammatory disease after a COVID-19 infection or vaccination. Of these, 11 were transverse myelitis, 6 were optic neuritis, and 3 were encephalomyelitis. This patient adds to a growing pool of data indicating that COVID-19 infection or vaccination could unmask underlying central nervous system neuroinflammatory conditions.

While the resulting inflammation may be insidious, it is treatable. The researchers emphasize that while the resulting inflammation may be insidious, it is treatable, and the “benefits of [the COVID-19] vaccination outweigh the smaller risk of unmasking an immune-related condition.”


Roy S, Barreras P, Pardo C, Newsome SD. Unmasking of a relapsing encephalomyelitis after SARS-CoV-2 infection and COVID-19 infection. Presented at: CMSC 2022 Annual Meeting; June 1-4, 2022; National Harbor, Maryland. Abstract CSR04.