Risk and characteristics of Bell’s palsy in adults as an adverse event following COVID-19 vaccination: a retrospective study

Abstract

Background Although an association between COVID-19 vaccination and Bell’s palsy (BP) has been reported, a clear causal relationship has not been elucidated. We investigated the risk and clinical characteristics of BP after COVID-19 vaccination. Methods This retrospective chart review evaluated the association between COVID-19 vaccination and BP by comparing the number of patients diagnosed with BP during the pre-COVID-19 vaccination period (March 2018–February 2021) and the COVID-19 mass vaccination period (March 2021–February 2022). We then compared vaccine-related (time between vaccination and BP onset < 42 days) and -unrelated (time interval ≥ 42 days or non-vaccination) clinical characteristics in newly diagnosed patients with BP. Results BP occurred more during the COVID-19 vaccination period than in the previous three pre-vaccination years. Thirteen patients developed BP within 42 days of vaccination. All patients, except one, developed BP after mRNA-based vaccination, with most cases (9/13, 69.2%) occurring after the second or third dose. Thirteen patients with vaccine-related BP were younger (age 43.92 ± 13.14 vs. 54.32 ± 16.01 years; p = 0.033) and more frequently experienced taste changes (58.8% vs. 10.9%; p = 0.002) than 52 patients with vaccine-unrelated BP. Patients with vaccine-related BP had a greater likelihood of good and faster ( p = 0.042) facial nerve function recovery than those with vaccine-unrelated BP (100% vs. 78%). Conclusion COVID-19 vaccines, especially mRNA-based vaccines, may be associated with BP cases with distinctive clinical characteristics, which occur more frequently in young individuals, are frequently accompanied by taste changes, and have fast and good recovery.

Association of Coronavirus Disease 2019 Vaccination with Facial-Related Neurological Disorders: A Nationwide Retrospective Cohort Study

“…In a retrospective study of 13 patients who developed facial palsy within 42 days after vaccination, Kim et al reported that COVID-19 vaccines, especially mRNA vaccines, may be correlated with facial palsy with distinct clinical characteristics, which occurs more frequently in young adults and is often accompanied by changes in taste. It showed faster and better recovery compared with vaccine-unrelated facial palsy [12]. In contrast, Shemer et al reported no increase in the risk of facial paralysis after vaccination in a case-control study involving 37 patients with acute-onset facial paralysis and matched controls [13].…”

Case Series of Acute Peripheral Neuropathies in Individuals Who Received COVID-19 Vaccination

“…A retrospective study by Kim et al found that Bell’s palsy occurred more during the COVID-19 vaccination period than in the three pre-vaccination years. In Bell’s palsy that had a timely relation with COVID-19 vaccination (<42 days, n = 13, 12/13 vaccinated with mRNA vaccines), compared to the vaccine-unrelated facial neuropathy, prognosis was better, and the patients were younger [ 18 ].…”

COVID-19 vaccine adverse events: Evaluating the pathophysiology from an undersulfated and degraded glycocalyx perspective

“…Symptoms related to pituitary gland involvement may include headaches and vision changes, while damage to the cerebellum and cortex can cause neurological symptoms such as ataxia, dizziness, and impaired consciousness 216,265 . Numerous cases of acute, temporary, unilateral peripheral facial paralysis, or Bell's palsy, have been reported as AE 49,259,266 .…”