Fulminant neuromyelitis optica spectrum disorder (NMOSD) following COVID-19 vaccination: A need for reconsideration?

During the coronavirus disease 2019 (COVID-19) pandemic, mass vaccination was a beneficial strategy in many countries. Nevertheless, reports of serious complications such as postvaccination neuromyelitis optica spectrum disorder (NMOSD) raised concerns about the safety of vaccines. Anamnart and colleagues explained postvaccination NMOSD following different vaccines, including COVID-19. To emphasize the message of this article, in this letter, we present a unique case of postvaccination NMOSD with a fulminant and fatal course, which may show a plausible relationship between COVID-19 vaccination and triggering anti-aquaporin-4 antibody (AQP4-Ab).

Abrupt bilateral blindness as a rare post-acute demyelinating consequence of COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could prompt various neurological complications. Abrupt visual disturbance was reported as a rare severe manifestation of post-coronavirus disease 2019 (COVID-19). Autoimmune conditions were assumed to have an undeniable role in creation of such circumstances. This report presents a 69-year-old woman with sudden bilateral blindness three weeks after recovering from a SARS-CoV-2 infection. Demyelination due to COVID-19-related autoimmune disorder of the central nervous system (CRAD-C) was considered to be the etiology of her bilateral blindness. Due to her progressive demyelination, immunosuppressive treatments were administered, which resulted in stabilizing post-COVID-19 demyelinating lesions. Accordingly, in the case of COVID-19-related neurological deficits, especially the acute and progressive symptoms, there should be great consideration of autoimmune response to prevent serious complications; hence early diagnosis, treatment, and long-term assessment of patients are necessitated.