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.
【저자키워드】 neuroscience, Neurological disorders, 【초록키워드】 public health, COVID-19 vaccine, vaccination, SARS-COV-2 infection, Infection, risk, outcome, Regulatory, BNT162b2, Cohort, COVID-19 vaccines, incidence rate, Complication, Hospital admission, England, Guillain–Barrè syndrome, association, Vaccinations, Analysis, neurological, Neurological complication, Support, Hemorrhagic Stroke, higher risk, 95% confidence interval, increased risk, first dose, positive, SARS-CoV-2 test, independent, highlight, greater, provided, receiving, case sery, Bell’s palsy, Scottish, with COVID-19, 【제목키워드】 COVID-19 vaccine, SARS-COV-2 infection, Complication, first dose,