Abstract
Introduction/aims: We aimed to determine whether specific severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccines may be associated with acute-onset polyradiculoneuropathy and if they may result in particular clinical presentations.
Methods: We retrospectively reviewed records of all persons presenting with acute-onset polyradiculoneuropathy from January 1, 2021, to June 30, 2021, admitted to two Neuroscience centers, of the West and North Midlands, United Kingdom. We compared subjects with previous SARS-CoV2 vaccine exposure with a local cohort of persons with acute-onset polyradiculoneuropathy admitted between 2005 and 2019 and compared admission numbers for the studied time frame with that of the previous 3 years.
Results: Of 24 persons with acute-onset polyradiculoneuropathy, 16 (66.7%) presented within 4 weeks after first SARS-CoV2 vaccine. Fourteen had received the AstraZeneca vaccine and one each, the Pfizer and Moderna vaccines. The final diagnosis was Guillain-Barré syndrome (GBS) in 12 and acute-onset chronic inflammatory demyelinating polyneuropathy in 4. Among AstraZeneca vaccine recipients, facial weakness in nine persons (64.3%), bulbar weakness in seven (50%), and the bifacial weakness and distal paresthesias GBS variant in three (21.4%), were more common than in historical controls (P = .01; P = .004, and P = .002, respectively). A 2.6-fold (95% confidence interval: 1.98-3.51) increase in admissions for acute-onset polyradiculoneuropathy was noted during the studied time frame, compared to the same period in the previous 3 years.
Discussion: Despite a low risk, smaller than that of SARS-CoV2 infection and its complications, exposure to the first dose of AstraZeneca SARS-CoV2 vaccine may be a risk factor for acute-onset polyradiculoneuropathy, characterized by more common cranial nerve involvement.
Keywords: Guillain-Barré syndrome; chronic inflammatory demyelinating polyradiculoneuropathy; polyradiculoneuropathy.
【저자키워드】 Guillain-barrè syndrome, polyradiculoneuropathy., chronic inflammatory demyelinating polyradiculoneuropathy, 【초록키워드】 Vaccine, coronavirus, SARS-CoV2, Vaccines, variant, Diagnosis, risk, Local, risk factor, SARS-CoV2 infection, Pfizer, Cohort, Control, complications, Time frame, neuroscience, United Kingdom, Admission, AstraZeneca, Moderna, Guillain-barrè syndrome, Inflammatory, Polyradiculoneuropathy, exposure to, final diagnosis, Cranial nerve, Polyneuropathy, Admissions, acute respiratory syndrome, Frame, Clinical presentations, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, recipients, subject, first dose, syndrome, Final, weakness, North, West, chronic inflammatory demyelinating polyneuropathy, Seven, nine, characterized, determine, increase in, presenting, cranial, distal, facial, 【제목키워드】 Vaccine, SARS-CoV2, North,