Martina Patone
Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection
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
Authors
Lahiru Handunnetthi
Defne Saatci
Jiafeng Pan
Srinivasa Vittal Katikireddi
Saif Razvi
David Hunt
Xue W. Mei
Sharon Dixon
Francesco Zaccardi
Kamlesh Khunti
Peter Watkinson
CAROL COUPLAND carol.coupland@nottingham.ac.uk
Professor of Medical Statistics
James Doidge
David A. Harrison
Rommel Ravanan
Aziz Sheikh
Chris Robertson
Julia Hippisley-Cox
Abstract
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.
Citation
Patone, M., Handunnetthi, L., Saatci, D., Pan, J., Katikireddi, S. V., Razvi, S., …Hippisley-Cox, J. (2021). Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection. Nature Medicine, 27(12), 2144-2153. https://doi.org/10.1038/s41591-021-01556-7
Journal Article Type | Article |
---|---|
Acceptance Date | Sep 24, 2021 |
Online Publication Date | Oct 25, 2021 |
Publication Date | Oct 25, 2021 |
Deposit Date | Nov 1, 2021 |
Publicly Available Date | Nov 2, 2021 |
Journal | Nature Medicine |
Print ISSN | 1078-8956 |
Electronic ISSN | 1546-170X |
Publisher | Nature Publishing Group |
Peer Reviewed | Peer Reviewed |
Volume | 27 |
Issue | 12 |
Pages | 2144-2153 |
DOI | https://doi.org/10.1038/s41591-021-01556-7 |
Keywords | Neurological complications; COVID-19 vaccines; SARS-CoV-2 infection |
Public URL | https://nottingham-repository.worktribe.com/output/6605260 |
Publisher URL | https://www.nature.com/articles/s41591-021-01556-7 |
Files
Patone Nature Medicine 2021
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