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1.
Int J Infect Dis ; 119: 184-186, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1838872

ABSTRACT

We present, to our knowledge, the second case report of a 46-year old female who developed varicella-zoster virus (VZV) meningitis after BNT162b2 mRNA COVID-19 vaccination. The patient is immunocompetent and has no known predisposing risk factors for developing VZV meningitis. The patient received acyclovir therapy and subsequently had a complete recovery. We describe possible mechanisms of VZV meningitis after mRNA COVID-19 vaccination.


Subject(s)
COVID-19 , Herpes Zoster , Meningitis , Adult , COVID-19/diagnosis , COVID-19 Vaccines/adverse effects , Female , Herpes Zoster/diagnosis , Herpes Zoster/drug therapy , Herpes Zoster/etiology , Herpesvirus 3, Human/genetics , Humans , Meningitis/complications , Middle Aged , RNA, Messenger , Vaccination/adverse effects
3.
BMJ Case Rep ; 15(4)2022 Apr 22.
Article in English | MEDLINE | ID: covidwho-1807346

ABSTRACT

This case report describes an 84-year-old man who presented with 3 weeks of gradually worsening right arm weakness associated with a painful vesicular rash across his arm. This occurred 3 days after his first dose of the ChAdOx1 nCoV-19/AZD1222 (University of Oxford, AstraZeneca and the Serum Institute of India) vaccine. The diagnosis was complicated by the presence of right C5-C6 foraminal stenosis compressing on the C6 nerve root sheath on non-contrast MRI, leading to an initial diagnosis of cervical radiculopathy. However, a positive varicella zoster virus-PCR test and findings of abnormal contrast enhancement of his right C5-C7 nerve roots on gadolinium-enhanced MRI resulted in a revision of his diagnosis to zoster radiculopathy. He was subsequently commenced on oral valacilovir and made significant recovery. This report aims to highlight the diagnostic dilemma between cervical radiculopathy secondary to spondylosis and zoster radiculopathy and how an erroneous diagnosis could result in inappropriate, aggressive surgical intervention and delayed treatment with antiviral therapy.


Subject(s)
Herpes Zoster , Radiculopathy , Aged, 80 and over , Herpes Zoster/complications , Herpes Zoster/diagnosis , Herpes Zoster/drug therapy , Herpesvirus 3, Human , Humans , Male , Radiculopathy/complications , Radiculopathy/etiology , Vaccination/adverse effects
4.
Rev Neurol ; 74(8): 280-283, 2022 Apr 16.
Article in Spanish | MEDLINE | ID: covidwho-1780451

ABSTRACT

INTRODUCTION: The SARS-CoV-2 virus, which causes COVID-19, could give rise to damage the nervous system. Many studies have been conducted on this topic, but few have focused specifically on encephalitis. The effect of SARS-CoV-2 on the clinical expression of other neurotropic viruses, such as Herpesviridae, is unknown. CASE REPORTS: We describe the cases of two young men (39 and 18 years old) in whom SARS-CoV-2 had been detected -reverse transcription polymerase chain reaction (RT-PCR)-, and with a clinical diagnosis and cerebrospinal fluid (CSF) analysis consistent with encephalitis. The first patient had a positive PCR for varicella zoster virus in CSF, while the second had a positive PCR for herpes simplex virus types 1 and 2. The first patient, who was recently diagnosed with human immunodeficiency virus, presented with fever, headache, vomiting, cough, inappropriate behaviour and epileptic seizures; the second was seen to have fever, headache, myalgia and exanthema. Both offered the same laboratory findings (lymphopenia and high interleukin 6). CSF showed pleocytosis with a predominance of monomorphonuclear cells, hyperproteinorrachia and normal glycorrhachia. A cranial CT scan showed only mild diffuse cerebral oedema in the first case. Both cases were treated with corticosteroids, antibiotics and acyclovir. The second progressed favourably, while the first did not. CONCLUSIONS: Little is known about co-infection of SARS-CoV-2 with neurotropic viruses, such as Herpesviridae, and we have only limited evidence of direct neurological involvement of SARS-CoV-2, due to the technical difficulty of detecting it in the nervous system, thus making it important to take co-infection into account in order to be able to establish an early diagnosis and treatment to improve prognosis.


TITLE: COVID-19 y encefalitis por herpesvirus.Introducción. El virus SARS-CoV-2, causante de la COVID-19, podría generar lesiones en el sistema nervioso. Son múltiples los estudios relacionados con esto, pero escasos en cuanto a la encefalitis en particular. A su vez, se desconoce el efecto del SARS-CoV-2 sobre la expresión clínica de otros virus neurótropos, como los Herpesviridae. Casos clínicos. Se describen dos casos de varones jóvenes, de 39 y 18 años, con detección de SARS-CoV-2 ­reacción en cadena de la polimerasa con transcripción inversa (RT-PCR)­, con diagnóstico clínico y análisis del líquido cefalorraquídeo (LCR) compatibles con encefalitis. En el primer paciente se obtuvo una PCR positiva para el virus de la varicela zóster en el LCR, mientras que, en el segundo, para el virus del herpes simple de los tipos 1 y 2. El primer paciente, con diagnóstico reciente positivo para el virus de la inmunodeficiencia humana, presentó fiebre, cefalea, vómitos, tos, conductas inapropiadas y crisis epiléptica; y el segundo, fiebre, cefalea, mialgias y exantema. Ambos compartieron hallazgos en la analítica (linfopenia e interleucina 6 elevada). En el LCR se observó pleocitosis con predominio de monomorfonucleares, hiperproteinorraquia y glucorraquia normal. La tomografía computarizada de cráneo sólo evidenció un edema cerebral difuso leve en el primer caso. En ambos casos se realizó un tratamiento con corticoides, antibióticos y aciclovir. En el segundo, la evolución fue favorable, mientras que en el primero, no. Conclusiones. Poco se conoce sobre la coinfección del SARS-CoV-2 con virus neurótropos, como los Herpesviridae, lo que se suma a la escasa evidencia de la afectación neurológica directa del SARS-CoV-2, debido a la dificultad técnica para su detección en el sistema nervioso, por lo que es importante considerar la coinfección para realizar un diagnóstico y un tratamiento precoces que mejoren el pronóstico.


Subject(s)
COVID-19 , Encephalitis , Acyclovir/therapeutic use , COVID-19/complications , Encephalitis/drug therapy , Herpesvirus 3, Human , Humans , Male , SARS-CoV-2
6.
Cornea ; 41(5): 649-650, 2022 May 01.
Article in English | MEDLINE | ID: covidwho-1778965

ABSTRACT

PURPOSE: The purpose of this study was to report a case of acute exacerbation in varicella-zoster virus (VZV) keratitis after SARS-CoV-2 vaccination. METHODS: An 87-year-old man, with a history of herpes zoster ophthalmicus 10 years ago, was referred for sudden visual impairment in his left eye that started 2 days after his second dose of SARS-CoV-2 mRNA vaccine BNT162b2. RESULTS: At presentation, his visual acuity was hand motion. Slitlamp examination revealed diffuse corneal stromal edema and nasal stromal infiltration. After treatment for 2 weeks with oral valacyclovir and topical corticosteroids, the problematic lesion was recovered and his visual acuity was restored to 20/30. CONCLUSIONS: We believe that this is the first report of possible association between recurrence of VZV keratitis and SARS-CoV-2 vaccination. We believe that T-cell activation by the host response after vaccination may affect the recurrence of VZV keratitis. Physicians should be aware of the potential of recurrence of VZV keratitis associated with the SARS-CoV-2 messenger RNA vaccine.


Subject(s)
COVID-19 , Herpes Zoster Ophthalmicus , Keratitis , Aged, 80 and over , COVID-19 Vaccines/adverse effects , Herpes Zoster Ophthalmicus/complications , Herpes Zoster Ophthalmicus/diagnosis , Herpes Zoster Ophthalmicus/drug therapy , Herpesvirus 3, Human/genetics , Humans , Keratitis/diagnosis , Male , SARS-CoV-2 , Vaccination , Vaccines, Synthetic
7.
Indian J Public Health ; 66(1): 83-85, 2022.
Article in English | MEDLINE | ID: covidwho-1776455

ABSTRACT

Ever since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, science has unraveled much knowledge on SARS-CoV-2 which has led to extraordinary and unprecedented progress in developing COVID-19 vaccines. Several adverse cutaneous reactions, ranging from more common local injection site reaction, neutrophilic and pustular drug reactions to flare-up of preexisting dermatoses, have been reported with currently available vaccines. We report a case series of 7 patients who developed herpes zoster (HZ) following the first dose of ChAdOx1 nCoV-19 coronavirus vaccine (recombinant). HZ following vaccination is a rare entity. The occurrence of HZ in the patients presented in this series within the time window 1-21 days after vaccination defined for increased risk and postulated dysregulation of T-cell-mediated immunity, suggests that the ChAdOx1 nCoV-19 coronavirus vaccine (recombinant) could probably be a trigger for reactivation of varicella zoster virus to cause HZ in them.


Subject(s)
COVID-19 , Herpes Zoster , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Herpes Zoster/epidemiology , Herpes Zoster/etiology , Herpes Zoster/prevention & control , Herpesvirus 3, Human , Humans , India , SARS-CoV-2 , Vaccination/adverse effects
8.
Front Public Health ; 9: 738412, 2021.
Article in English | MEDLINE | ID: covidwho-1775888

ABSTRACT

BACKGROUND: Unbiased metagenomic next-generation sequencing (mNGS) detects pathogens in a target-independent manner. It is not well-understood whether mNGS has comparable sensitivity to target-dependent nucleic acid test for pathogen identification. METHODS: This study included 31 patients with chickenpox and neurological symptoms for screening of possible varicella-zoster virus (VZV) central nervous system (CNS) infection. Microbiological diagnosing of VZV cerebrospinal fluid (CSF) infection was performed on stored CSF samples using mNGS, quantitative and qualitative VZV-specific PCR assays, and VZV IgM antibodies test. RESULTS: The median age was 30.0 [interquartile range (IQR), 24.3-33.3] years. 51.6% of the patients were men. About 80.6% of the patients had normal CSF white blood cell counts (≤ 5 × 106/L). VZV IgM antibodies presented in 16.1% of the CSF samples, and nucleic acids were detectable in 16.1 and 9.7% using two different VZV-specific real-time PCR protocols. Intriguingly, maximal identification of VZV elements was achieved by CSF mNGS (p = 0.001 and p = 007; compared with qualitative PCR and VZV IgM antibody test, respectively), with sequence reads of VZV being reported in 51.6% (16/31) of the CSF samples. All VZV PCR positive samples were positive when analyzed by mNGS. Of note, human betaherpesvirus 6A with clinical significance was unexpectedly detected in one CSF sample. CONCLUSIONS: Our study suggests that CSF mNGS may have higher sensitivity for VZV detection than CSF VZV PCR and antibody tests, and has the advantage of identifying unexpected pathogens.


Subject(s)
Central Nervous System Infections , Chickenpox , Adult , Central Nervous System , Herpesvirus 3, Human/genetics , High-Throughput Nucleotide Sequencing/methods , Humans , Male
9.
Int J Infect Dis ; 119: 214-216, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1763772

ABSTRACT

Most of the adverse effects reported in patients who have received COVID-19 vaccines have been mild. However, possible serious adverse effects are being monitored cautiously. There have also been a number of case reports of reactivation of varicella zoster infection within 28 days after immunization with mRNA COVID-19 vaccines. A few cases have also been reported after viral vector and inactivated COVID-19 vaccination. The incidence of meningitis following varicella zoster virus infection is rare. In the current study, we report two cases of male patients who received two different types of COVID-19 vaccine (inactivated and viral vector) and developed varicella zoster meningitis within 10 days after vaccination.


Subject(s)
COVID-19 , Chickenpox , Drug-Related Side Effects and Adverse Reactions , Herpes Zoster , Meningitis , COVID-19 Vaccines/adverse effects , Chickenpox/prevention & control , Chickenpox Vaccine/adverse effects , Drug-Related Side Effects and Adverse Reactions/etiology , Herpes Zoster/diagnosis , Herpes Zoster/epidemiology , Herpes Zoster/etiology , Herpesvirus 3, Human , Humans , Male , Meningitis/etiology , Vaccination/adverse effects
13.
Expert Rev Vaccines ; 21(5): 675-684, 2022 May.
Article in English | MEDLINE | ID: covidwho-1706199

ABSTRACT

BACKGROUND: A few cases of Herpes Zoster and Simplex reactivation following COVID-19 immunization have been recently described, but the real extent of this suspected adverse event has not been elucidated yet. METHODS: We performed a nested case/control study by using the U.S. Vaccine Adverse Event Reporting System database. We carried out a case-level clinical review of all Herpes reactivation cases following the administration of COVID-19 vaccines. For cases and controls, significance was set at P = 0.05, differential risk of reporting was assessed for each vaccine as reporting odds ratio and incidence was estimated based on the total number of vaccine doses administered. RESULTS: Of 6,195 cases included in the analysis (5,934 and 273 reporting Herpes Zoster and Herpes Simplex, respectively) over 90% were non-serious. We found a slightly higher risk of reporting both for Zoster (ROR = 1.49) and Simplex (ROR = 1.51) infections following the Pfizer-BioNTech vaccine. The estimated incidence was approximately 0.7/100,000 and 0.03/100,000 for Zoster and Simplex, respectively. CONCLUSIONS: The paucity of cases (almost all of non-serious nature) makes the potential occurrence of this adverse effect negligible from clinical standpoints, thus supporting the good safety profile of the COVID-19 vaccination, which remains strongly recommended.


Subject(s)
COVID-19 , Herpes Simplex , Herpes Zoster Vaccine , Herpes Zoster , Vaccines , Adverse Drug Reaction Reporting Systems , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Herpes Zoster/epidemiology , Herpes Zoster/prevention & control , Herpes Zoster Vaccine/adverse effects , Herpesvirus 3, Human , Humans , Vaccination/adverse effects , Vaccines/adverse effects
15.
Can J Microbiol ; 68(5): 303-314, 2022 May.
Article in English | MEDLINE | ID: covidwho-1685702

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a potential health threat in the highly mobile society of the world. There are also concerns regarding the occurrence of co-infections occurring in COVID-19 patients. Herpes zoster (HZ) is currently being reported as a co-infection in COVID-19 patients. It is a varicella-zoster virus induced viral infection affecting older and immunocompromised individuals. Reactivation of HZ infection in COVID-19 patients are emerging and the mechanism of reactivation is still unknown. The most convincing argument is that increased psychological and immunological stress leads to HZ in COVID-19 patients; this review justifies this argument.


Subject(s)
COVID-19 , Herpes Zoster , Herpes Zoster/complications , Herpes Zoster/epidemiology , Herpesvirus 3, Human , Humans , Immunocompromised Host
16.
Expert Rev Vaccines ; 21(5): 601-608, 2022 May.
Article in English | MEDLINE | ID: covidwho-1671955

ABSTRACT

BACKGROUND: Following COVID-19 vaccination, several herpes zoster cases have been reported, making it critical to explore the association between herpes zoster and COVID-19 vaccination. This is especially true in the context of increasing the number of participants enrolled to receive COVID-19 vaccination. RESEARCH DESIGN AND METHODS: Three databases, including the Cochrane Library, PubMed, and EMBASE, were searched for relevant studies before 25 December 2021 according to preliminarily determined inclusion and exclusion criteria without any language limitations. Four cohort studies were included in this systematic review and meta-analysis. RESULTS: Compared with the placebo group, there was no evidence that the COVID-19 vaccination group was associated with increased incidence of herpes zoster (Risk ratio [RR]: 1.06; 95% confidence interval [CI]: 0.91 to 1.24). There is no evidence that the COVID-19 vaccination from Moderna is associated with the incidence of herpes zoster compared with vaccination from Pfizer (RR: 0.20; 95% CI: 0.01 to 2.99). CONCLUSIONS: To date, there is no evidence of an association between covid-19 vaccination and herpes zoster.


Subject(s)
COVID-19 , Herpes Zoster Vaccine , Herpes Zoster , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Herpes Zoster/epidemiology , Herpes Zoster/prevention & control , Herpes Zoster Vaccine/adverse effects , Herpesvirus 3, Human , Humans , Vaccination
18.
J Med Case Rep ; 16(1): 45, 2022 Jan 24.
Article in English | MEDLINE | ID: covidwho-1650762

ABSTRACT

BACKGROUND: The spectrum of clinical manifestations and differential diagnosis associated with coronavirus disease 2019 is broad, ranging from fever and cutaneous eruptions to respiratory distress or even neurological disorders. Coexisting multipathogen infections significantly increase the complexity of the proper diagnostic and therapeutic approach and correlate with the rate of intensive care unit admissions and in-hospital mortality. CASE PRESENTATION: We present a case of multipathogen respiratory infection with severe acute respiratory syndrome coronavirus 2, varicella zoster virus, and polymicrobial tracheobronchitis in a 48-year-old Caucasian male hospitalized after traumatic brain injury. The patient tested positive for severe acute respiratory syndrome coronavirus 2 infection upon admission. During his stay in the intensive care unit, the patient developed a vesicular exanthema along with respiratory failure and signs of septic shock. CONCLUSION: This case of an adult presenting with severe acute respiratory syndrome coronavirus 2 infection and simultaneous primary varicella zoster virus infection illustrates the importance of considering coinfections in patients with coronavirus disease 2019 with unusual clinical manifestations.


Subject(s)
COVID-19 , Coinfection , Herpes Zoster , Adult , Herpesvirus 3, Human , Humans , Male , Middle Aged , SARS-CoV-2 , Ventilators, Mechanical
19.
Hum Vaccin Immunother ; 18(1): 2027196, 2022 12 31.
Article in English | MEDLINE | ID: covidwho-1631418

ABSTRACT

Due to COVID-19, vaccinations dropped in 2020 and 2021. We estimated the impact of reduced recombinant zoster vaccine (RZV) use on herpes zoster (HZ) cases, complications, and quality-adjusted life-year (QALY) losses among older adults. Various scenarios were compared with Markov models using data from national sources, clinical trials, and literature. Missed series initiations were calculated based on RZV distributed doses. In 2020, 3.9 million RZV series initiations were missed, resulting in 31,945 HZ cases, 2,714 postherpetic neuralgia cases, and 610 lost QALYs. Scenarios further projected disease burden increases if individuals remain unvaccinated in 2021 or the same number of initiations are missed in 2021. Health professionals should emphasize the importance of vaccination against all preventable diseases during the COVID-19 era.


Subject(s)
COVID-19 , Herpes Zoster Vaccine , Herpes Zoster , Neuralgia, Postherpetic , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Cost-Benefit Analysis , Herpes Zoster/epidemiology , Herpes Zoster/prevention & control , Herpesvirus 3, Human , Humans , Neuralgia, Postherpetic/epidemiology , Neuralgia, Postherpetic/prevention & control , Pandemics , United States/epidemiology , Vaccination , Vaccines, Synthetic
20.
Viruses ; 14(2)2022 01 19.
Article in English | MEDLINE | ID: covidwho-1625634

ABSTRACT

The Varicella-zoster virus (VZV) or human herpes virus 3 is a neurotropic human alpha herpes virus responsible for chickenpox/varicella and shingles/Herpes zoster (HZ). This review will focus on HZ. Since HZ is secondary to varicella, its incidence increases with age. In children and youngsters, HZ is rare and associated to metabolic and neoplastic disorders. In adults, advanced age, distress, other infections (such as AIDS or COVID-19), and immunosuppression are the most common risk factors. HZ reactivation has recently been observed after COVID-19 vaccination. The disease shows different clinical stages of variable clinical manifestations. Some of the manifestations bear a higher risk of complications. Among the possible complications, postherpetic neuralgia, a chronic pain disease, is one of the most frequent. HZ vasculitis is associated with morbidity and mortality. Renal and gastrointestinal complications have been reported. The cornerstone of treatment is early intervention with acyclovir or brivudine. Second-line treatments are available. Pain management is essential. For (secondary) prophylaxis, currently two HZV vaccines are available for healthy older adults, a live attenuated VZV vaccine and a recombinant adjuvanted VZV glycoprotein E subunit vaccine. The latter allows vaccination also in severely immunosuppressed patients. This review focuses on manifestations of HZ and its management. Although several articles have been published on HZ, the literature continues to evolve, especially in regard to patients with comorbidities and immunocompromised patients. VZV reactivation has also emerged as an important point of discussion during the COVID-19 pandemic, especially after vaccination. The objective of this review is to discuss current updates related to clinical presentations, complications, and management of HZ.


Subject(s)
Disease Management , Herpes Zoster/drug therapy , Herpes Zoster/prevention & control , Herpesvirus 3, Human/pathogenicity , Herpesvirus Vaccines/immunology , Herpes Zoster/complications , Herpes Zoster/physiopathology , Herpesvirus Vaccines/administration & dosage , Herpesvirus Vaccines/classification , Humans , Immunocompromised Host , Incidence , Latent Infection/virology , Morbidity , Neuralgia, Postherpetic/virology , Risk Factors , Vaccination , Vaccines, Synthetic/administration & dosage
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