Lessons of the month 1: Longitudinal extensive transverse myelitis following AstraZeneca COVID-19 vaccination

Clin Med (Lond). 2021 Sep;21(5):e535-e538. doi: 10.7861/clinmed.2021-0470.


Longitudinal extensive transverse myelitis (LETM) is a rare but recognised complication of vaccination. We report the case of a 58-year-old man admitted to hospital 10 days after his first AstraZeneca COVID-19 vaccination with progressive neurological symptoms and signs, and investigations and imaging consistent with LETM.This case reviews the literature and the investigative process behind excluding other diagnoses given the patient's background of pulmonary sarcoidosis. It is unique in being the first UK report of a case of LETM with a strong temporal link to COVID-19 vaccination.

Keywords: AstraZeneca; COVID-19; longitudinal extensive transverse myelitis; myelitis; vaccination.

Publication types

  • Case Reports

MeSH terms

  • COVID-19 Vaccines
  • COVID-19*
  • Humans
  • Male
  • Middle Aged
  • Myelitis, Transverse* / chemically induced
  • Myelitis, Transverse* / drug therapy
  • SARS-CoV-2
  • Vaccination / adverse effects


  • COVID-19 Vaccines