Guillain‐Barré syndrome following ChAdOx1 nCoV‐19 COVID‐19 vaccination: A case series

James, Joe; Jose, James; Gafoor, V Abdul; Smita, B.; Balaram, Neetha

doi:10.1111/ncn3.12537

Cited by 28 publications

(16 citation statements)

References 9 publications

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“…Furthermore, the phenotype of the reported cases of GBS in the surveillance study gives no recognisable vaccine-specific GBS features unlike the Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT), with recognisable features and a biomarker in the anti-PF4 antibodies. 11 Cases of severe (bi)-facial palsy have been widely discussed, 23-26 yet this feature does not occur more often than in the non-vaccine associated cases in our dataset. Likewise, no other feature stands out as different or specific.…”

Section: Discussionmentioning

confidence: 69%

COVID-19 vaccination and Guillain-Barré syndrome: analyses using the National Immunoglobulin Database

Keh

Scanlon²,

Datta-Nemdharry³

et al. 2021

Preprint

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Vaccination against viruses has rarely been associated with Guillain-Barré syndrome (GBS). An association with the COVID-19 vaccine is unknown. We performed a population-based study of National Health Service (NHS) data in England and a multicentre surveillance study from UK hospitals, to investigate the relationship between COVID-19 vaccination and GBS.Firstly, we present a retrospective analysis of every GBS patient in England in the National Immunoglobulin Database (NID) linked with their COVID-19 vaccination data. Cases of GBS identified in the National Immunoglobulin Database (NID) from 8 December 2021 to 8 July 2021 were linked to data from the National Immunisation Management System (NIMS) in England to identify exposure to a COVID-19 vaccine. For the NID/NIMS linked dataset, GBS cases temporally associated with vaccination within a 6-week risk window of any COVID-19 vaccine were identified. Secondly, we prospectively collected incident UK GBS cases from 1 January 2021 to 7 November 2021 in a separate UK multicentre surveillance database, regardless of vaccine exposure, with vaccine timings and GBS phenotypic data. For this multicentre UK surveillance dataset, we explored phenotypes of reported GBS cases to identify features of COVID-19 vaccine-associated GBS.996 GBS cases were recorded in the NID from January to October 2021. A spike of GBS cases above the 2016-2020 average occurred in March-April 2021. In England, among all cases of GBS, 198 occurred within 6 weeks of the first-dose COVID-19 vaccination (0.618 cases per 100,000 vaccinations, 176 ChAdOx1 nCoV-19 (AstraZeneca), 21 tozinameran (Pfizer), 1 mRNA-1273 (Moderna)). The excess of GBS occurs with a peak at 24 days; first-doses of ChAdOx1 nCoV-19 accounted for the excess. No excess was seen for second-dose vaccination. The absolute number of excess GBS cases was between 98-140 cases for first-dose ChAdOx1 nCoV-19 vaccination from January-July 2021. First-dose tozinameran and second-dose of any vaccination showed no excess GBS risk. 121 patients were reported in the separate multicentre surveillance dataset with no phenotypic or demographic differences identified between vaccinated and non-vaccinated GBS cases.Data from the linked NID/NIMS dataset suggest that first-dose ChAdOx1 nCoV-19vaccination is associated with an excess GBS risk of 0.576 (95%CI 0.481-0.691) cases per 100,000 doses. However, further data reported from a multicentre surveillance dataset suggest that no specific clinical features, including facial weakness, are associated with vaccination-related GBS compared to non-vaccinated cases. The pathogenic cause of the ChAdOx1 nCoV-19specific first dose link warrants further study.

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Section: Discussionmentioning

confidence: 69%

COVID-19 vaccination and Guillain-Barré syndrome: analyses using the National Immunoglobulin Database

Keh

Scanlon²,

Datta-Nemdharry³

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…Thirty-four articles, comprising 57 patients, were included in this study [ 4 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. The search and selection process are detailed in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

Prognosis of Guillain–Barré Syndrome Linked to COVID-19 Vaccination

et al. 2022

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There have been increasing reports of Guillain–Barré syndrome (GBS), a rare but debilitating neurological disease, occurring post-COVID-19 vaccination. However, the outcomes and relationships between patient demographics and clinical outcomes of post-COVID-19 vaccination GBS remain unclear. To bridge this gap, our study investigates the outcomes and clinical factors associated with poorer GBS outcomes following COVID-19 vaccination. We conducted a review and pooled analysis of detailed data extracted from 57 published cases with the relevant search strategies and criteria. The groups compared included male versus female patients, 1st dose versus 2nd dose and early onset versus late onset of GBS. Multivariate regression analysis was performed to compare the vaccine type, clinical severity and post-treatment outcomes between these groups of patients. Our results highlight for the first time that females were significantly more likely to have severe clinical presentation and poorer outcomes compared to males. Additionally, viral vector vaccines were the predominant vaccine type administered in early-onset post-COVID-19-vaccination GBS and GBS occurring after the 1st vaccination dose. It was also shown that reported cases of post-vaccination GBS generally displayed a positive response to conventional treatment and had favourable post-treatment outcomes. Through this study, we have established important links and provided assuring evidence for treatment response and post-treatment outcomes of GBS occurring post-COVID-19 vaccination. While the COVID-19 vaccination brings about much greater benefits than risks, our findings provide further impetus for greater vigilance in certain patient groups and more studies to explore the mechanisms behind these links.

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“…Pfizer and Moderna vaccines, constructed as messenger RNA vaccines, may trigger an autoimmune response, leading to the formation of antibodies against the myelin sheath [14]. AstraZeneca (ChAdOx1) and the Johnson and Johnson vaccine contain the Simian adenovirus as a vector, which induces antibodies against the spike glycoprotein of SARS-CoV-2 for immune system recognition [48,49]. Waheed et al were the first to report a case of GBS following COVID-19 vaccination with the Pfizer vaccine.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of Neuroimaging Findings in Post-COVID-19 Vaccination: A Case Series and Review of Literature

Sriwastava

Shrestha

Khalid

et al. 2021

Neurology International

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Background and Purpose: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in Wuhan, China in December 2019. Symptoms range from mild flu-like symptoms to more severe presentations, including pneumonia, acute respiratory distress syndrome (ARDS), and even death. In response to the COVID-19 pandemic, the Emergency Use Authorization (EUA) approved the use of several vaccines. Because vaccines have been fast-tracked for emergency use, the short and long-term safety profile has been an area of concern. The aim of this paper is to extensively review published literature regarding post-COVID-19 vaccination neurological complications and characterize neuroimaging findings from three case presentations for early diagnosis and treatment. Methods: The analysis includes data from PubMed and Google Scholar. Articles included were retrieved from database inception beginning December 2020 with no language restrictions. Terms used include “SARS-CoV-2”, “post Covid vaccination”, “neurological complications”, “Guillain-barre Syndrome”, “Transverse-myelitis”, “Cerebral Venous Sinus thrombosis”, and “Cerebral hemorrhage”. Results: The literature review yielded several neurological complications post vaccination, including cerebral sinus venous thrombosis, transverse myelitis, Guillain-Barré Syndrome and optic neuritis, to name a few. Patient case presentation findings were consistent with documented results in published literature. Conclusions: We present a case series with a thorough literature review documenting adverse neurological affects following COVID-19 vaccination. Our case presentations and literature review highlight the importance of neuroimaging when diagnosing post-COVID-19 vaccination adverse effects. MRI imaging study is an important tool to be considered in patients presenting with post-COVID-19 vaccination-related unexplained neurological symptoms for accurate diagnosis.

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Guillain‐Barré syndrome following ChAdOx1 nCoV‐19 COVID‐19 vaccination: A case series

Cited by 28 publications

References 9 publications

COVID-19 vaccination and Guillain-Barré syndrome: analyses using the National Immunoglobulin Database

COVID-19 vaccination and Guillain-Barré syndrome: analyses using the National Immunoglobulin Database

Prognosis of Guillain–Barré Syndrome Linked to COVID-19 Vaccination

Spectrum of Neuroimaging Findings in Post-COVID-19 Vaccination: A Case Series and Review of Literature

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