Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection

Emerging reports of rare neurological complications associated with COVID-19 infection and vaccinations are leading to regulatory, clinical and public health concerns. We undertook a self-controlled case series study to investigate hospital admissions from neurological complications in the 28 days a...

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Vydáno v:	Nature medicine Ročník 27; číslo 12; s. 2144 - 2153
Hlavní autoři:	Patone, Martina, Handunnetthi, Lahiru, Saatci, Defne, Pan, Jiafeng, Katikireddi, Srinivasa Vittal, Razvi, Saif, Hunt, David, Mei, Xue W., Dixon, Sharon, Zaccardi, Francesco, Khunti, Kamlesh, Watkinson, Peter, Coupland, Carol A. C., Doidge, James, Harrison, David A., Ravanan, Rommel, Sheikh, Aziz, Robertson, Chris, Hippisley-Cox, Julia
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	New York Nature Publishing Group US 01.12.2021 Nature Publishing Group
Témata:	631/378 692/617/375 Adolescent Adult Aged Aged, 80 and over Bell Palsy - epidemiology Bell Palsy - virology Bell's palsy Biomedical and Life Sciences Biomedicine BNT162 Vaccine - adverse effects BNT162 Vaccine - immunology Cancer Research ChAdOx1 nCoV-19 - adverse effects ChAdOx1 nCoV-19 - immunology Confidence intervals Coronaviruses COVID-19 COVID-19 - diagnosis COVID-19 - immunology COVID-19 - pathology COVID-19 vaccines Diagnosis England - epidemiology Female Guillain-Barre syndrome Guillain-Barre Syndrome - epidemiology Guillain-Barre Syndrome - virology Hemorrhage Hemorrhagic Stroke - epidemiology Hemorrhagic Stroke - virology Hospitalization - statistics & numerical data Humans Immunization Infections Infectious Diseases Male Metabolic Diseases Middle Aged Molecular Medicine Nervous System Diseases - epidemiology Nervous System Diseases - virology Neurological complications Neurosciences Paralysis Patient outcomes Public health Risk Risk factors SARS-CoV-2 - immunology Scotland - epidemiology Severe acute respiratory syndrome coronavirus 2 Stroke Vaccines Young Adult England Scotland United Kingdom
ISSN:	1078-8956, 1546-170X, 1546-170X
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Shrnutí:	Emerging reports of rare neurological complications associated with COVID-19 infection and vaccinations are leading to regulatory, clinical and public health concerns. We undertook a self-controlled case series study to investigate hospital admissions from neurological complications in the 28 days after a first dose of ChAdOx1nCoV-19 ( n = 20,417,752) or BNT162b2 ( n = 12,134,782), and after a SARS-CoV-2-positive test ( n = 2,005,280). There was an increased risk of Guillain–Barré syndrome (incidence rate ratio (IRR), 2.90; 95% confidence interval (CI): 2.15–3.92 at 15–21 days after vaccination) and Bell’s palsy (IRR, 1.29; 95% CI: 1.08–1.56 at 15–21 days) with ChAdOx1nCoV-19. There was an increased risk of hemorrhagic stroke (IRR, 1.38; 95% CI: 1.12–1.71 at 15–21 days) with BNT162b2. An independent Scottish cohort provided further support for the association between ChAdOx1nCoV and Guillain–Barré syndrome (IRR, 2.32; 95% CI: 1.08–5.02 at 1–28 days). There was a substantially higher risk of all neurological outcomes in the 28 days after a positive SARS-CoV-2 test including Guillain–Barré syndrome (IRR, 5.25; 95% CI: 3.00–9.18). Overall, we estimated 38 excess cases of Guillain–Barré syndrome per 10 million people receiving ChAdOx1nCoV-19 and 145 excess cases per 10 million people after a positive SARS-CoV-2 test. In summary, although we find an increased risk of neurological complications in those who received COVID-19 vaccines, the risk of these complications is greater following a positive SARS-CoV-2 test. A self-controlled case series analysis of nearly 32 million people in England shows an increased risk of rare neurological complications in those who received COVID-19 vaccines and following SARS-CoV-2 infection. The results highlight 38 excess cases of Guillain–Barré syndrome per 10 million ChAdOx1nCoV-19 vaccinations.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	1078-8956 1546-170X 1546-170X
DOI:	10.1038/s41591-021-01556-7