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...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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Springer Nature
2021
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| _version_ | 1826311719118438400 |
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| author | Patone, M Handunnetthi, L Saatci, D Pan, J Katikireddi, SV Razvi, S Hunt, D Mei, XW Dixon, S Zaccardi, F Khunti, K Watkinson, P Coupland, CAC Doidge, J Harrison, DA Ravanan, R Sheikh, A Robertson, C Hippisley-Cox, J |
| author_facet | Patone, M Handunnetthi, L Saatci, D Pan, J Katikireddi, SV Razvi, S Hunt, D Mei, XW Dixon, S Zaccardi, F Khunti, K Watkinson, P Coupland, CAC Doidge, J Harrison, DA Ravanan, R Sheikh, A Robertson, C Hippisley-Cox, J |
| author_sort | Patone, M |
| collection | OXFORD |
| description | 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 (<i>n</i> = 20,417,752) or BNT162b2 (<i>n</i> = 12,134,782), and after a SARS-CoV-2-positive test (<i>n</i> = 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. |
| first_indexed | 2024-03-07T08:15:23Z |
| format | Journal article |
| id | oxford-uuid:40c0dbe8-254c-41a1-a712-27773168366e |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:15:23Z |
| publishDate | 2021 |
| publisher | Springer Nature |
| record_format | dspace |
| spelling | oxford-uuid:40c0dbe8-254c-41a1-a712-27773168366e2023-12-21T15:46:16ZNeurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infectionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:40c0dbe8-254c-41a1-a712-27773168366eEnglishSymplectic ElementsSpringer Nature2021Patone, MHandunnetthi, LSaatci, DPan, JKatikireddi, SVRazvi, SHunt, DMei, XWDixon, SZaccardi, FKhunti, KWatkinson, PCoupland, CACDoidge, JHarrison, DARavanan, RSheikh, ARobertson, CHippisley-Cox, JEmerging 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 (<i>n</i> = 20,417,752) or BNT162b2 (<i>n</i> = 12,134,782), and after a SARS-CoV-2-positive test (<i>n</i> = 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. |
| spellingShingle | Patone, M Handunnetthi, L Saatci, D Pan, J Katikireddi, SV Razvi, S Hunt, D Mei, XW Dixon, S Zaccardi, F Khunti, K Watkinson, P Coupland, CAC Doidge, J Harrison, DA Ravanan, R Sheikh, A Robertson, C Hippisley-Cox, J Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection |
| title | Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection |
| title_full | Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection |
| title_fullStr | Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection |
| title_full_unstemmed | Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection |
| title_short | Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection |
| title_sort | neurological complications after first dose of covid 19 vaccines and sars cov 2 infection |
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