Neurological Complications Following COVID-19 Infection and COVID-19 Vaccination

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "COVID-19 Vaccines and Vaccination".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 17842

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Guest Editor
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
Interests: global health; public health; health disparities; global neurosurgery; global neurology; neuroscience
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Special Issue Information

Dear Colleagues,

Since 2019, the COVID-19 pandemic has accounted for more than 400 thousand deaths globally, with reports suggesting that COVID-19 infection is associated with increased risk of thrombosis and stroke. In addition, data from survivors who are experiencing long COVID-19 still indicate that some neurological complications are associated with the disease. Although these reports are rare, they are important in enabling health professionals to fully understand the disease and improve the existing management of COVID-19 patients.

On the other hand, several COVID-19 vaccines have been developed, evaluated, and approved for roll-out in the population, with clinical trials and real-life data confirming their general safety and efficacy. The vaccines are generally effective and safe to administer to the population, except for some high-risk individuals who experience rare side effects, such as vaccine-induced thrombocytopenia, upon taking adenovirus-associated vaccines. The COVID-19 vaccine uses different technologies and can be  adenovirus-associated, mRNA-based, or live-attenuated. Although these approved vaccines are effective in reducing the severity of COVID-19, they have variable safety profiles; therefore, the accurate selection of individuals who can be administered these vaccines is required for maximum safety. A few case reports have shown the occurrence of very uncommon neurological complications following vaccination, such as facial nerve palsy and Guillain-Barre syndrome.

The neurological complications associated with COVID-19 itself and COVID-19 vaccines have still not been extensively studied, and as such, are not fully understood. Therefore, the focus of this Special Issue is on neurological complications following COVID-19 and COVID-19 vaccines.

Dr. Ahmed Negida
Guest Editor

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Keywords

  • COVID-19
  • vaccine
  • global health
  • neurological complications

Published Papers (4 papers)

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17 pages, 2088 KiB  
Article
Fatigue Potentially Reduces the Effect of Transcranial Magnetic Stimulation on Depression Following COVID-19 and Its Vaccination
by Ayane Kamamuta, Yuki Takagi, Mizuki Takahashi, Kana Kurihara, Hibiki Shibata, Kanata Tanaka and Katsuhiko Hata
Vaccines 2023, 11(7), 1151; https://doi.org/10.3390/vaccines11071151 - 25 Jun 2023
Cited by 1 | Viewed by 2322
Abstract
COVID-19’s long-term effects, known as Long-COVID, present psychiatric and physical challenges in recovered patients. Similarly, rare long-term post-vaccination side effects, resembling Long-COVID, are emerging (called Post-Vaccine). However, effective treatments for both conditions are scarce. Our clinical experience suggests that transcranial magnetic stimulation (TMS) [...] Read more.
COVID-19’s long-term effects, known as Long-COVID, present psychiatric and physical challenges in recovered patients. Similarly, rare long-term post-vaccination side effects, resembling Long-COVID, are emerging (called Post-Vaccine). However, effective treatments for both conditions are scarce. Our clinical experience suggests that transcranial magnetic stimulation (TMS) often aids recovery in Long-COVID and Post-Vaccine patients. However, its effectiveness is reduced in patients with severe fatigue. Therefore, we retrospectively analysed Tokyo TMS Clinic’s outpatient records (60 in total; mean age, 38 years) to compare Long-COVID and post-vaccine patients’ characteristics and symptoms, assess the impact of TMS on their symptoms, and investigate the role of fatigue in depression recovery with TMS. The primary outcome was the regression coefficient of the initial fatigue score on depression score improvement using TMS. Secondary outcomes included psychiatric/physical scores before and after TMS and their improvement rates. We found no differences in the initial symptoms and background factors between Long-COVID and Post-Vaccine patients. After ten TMS sessions, all psychiatric and physical symptom scores improved significantly. TMS improves depression, insomnia, anxiety, and related neuropsychiatric symptoms, which were the primary complaints in this study. Thus, we conclude that TMS improves depression and anxiety. The effectiveness of TMS in treating depression in Long-COVID and Post-Vaccine patients decreased as fatigue severity increased. In conclusion, TMS relieved depressive symptoms following COVID-19 and vaccination; however, fatigue may hinder its effectiveness. Full article
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18 pages, 522 KiB  
Systematic Review
Parsonage–Turner Syndrome following COVID-19 Vaccination: A Systematic Review
by Elena Cecilia Rosca, Almonzer Al-Qiami, Amalia Cornea and Mihaela Simu
Vaccines 2024, 12(3), 306; https://doi.org/10.3390/vaccines12030306 - 14 Mar 2024
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Abstract
Background: Parsonage–Turner syndrome (PTS) is an inflammatory condition of the brachial plexus, with more than half of patients presenting a trigger, such as infection or vaccination. Our objective was to synthesize the clinical and paraclinical features, therapeutic responses, and outcomes of PTS post-COVID-19 [...] Read more.
Background: Parsonage–Turner syndrome (PTS) is an inflammatory condition of the brachial plexus, with more than half of patients presenting a trigger, such as infection or vaccination. Our objective was to synthesize the clinical and paraclinical features, therapeutic responses, and outcomes of PTS post-COVID-19 vaccination. Methods: We systematically reviewed two databases (LitCOVID and the WHO database on COVID-19) up to January 2024 following a published protocol (OSF registries). Results: We included 59 cases. PTS occurred more frequently in males (61.1% mRNA group, 83.3% viral vector group). Patients in the mRNA group were younger (41.7% between 41 and 50 years vs. 38.9% between 61 and 70 years). Most cases had sudden pain within two weeks. Unilateral PTS was present in 94.4% of mRNA and all viral vector-vaccinated cases. Symptoms included pain (97.1% and 92.3%, respectively), usually followed within two weeks by motor deficits (97.2% and 94.1%, respectively), amyotrophy (30% and 81.8%, respectively), paresthesia (50% and 27.3%, respectively), and sensory loss (33.3% and 38.5%, respectively). Viral vector vaccine recipients had nerve involvement outside the brachial plexus. Ancillary investigations revealed CSF albuminocytological dissociation (33.3% and 100%, respectively) and ipsilateral axillary lymphadenopathy. Two PTS cases worsened after the second mRNA dose, and another recurred after influenza vaccination. One patient well tolerated the second dose of the viral vector vaccine, but symptoms reemerged in another. Conclusions: Current evidence suggests PTS may occur after all COVID-19 vaccine types, with some subgroup differences. Also, PTS might recur with subsequent similar or unrelated vaccines. Full article
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27 pages, 621 KiB  
Systematic Review
Encephalitis following COVID-19 Vaccination: A Systematic Review
by Mariam Abdelhady, Muhammad Ashraf Husain, Yousef Hawas, Mahmoud Abdelsalam Elazb, Lena Said Mansour, Mohamed Mohamed, Maya Magdy Abdelwahab, Ahmed Aljabali and Ahmed Negida
Vaccines 2023, 11(3), 576; https://doi.org/10.3390/vaccines11030576 - 2 Mar 2023
Cited by 9 | Viewed by 6452
Abstract
Background: Since the advent of global COVID-19 vaccination, several studies reported cases of encephalitis with its various subtypes following COVID-19 vaccinations. In this regard, we conducted a systematic review to investigate and characterize the clinical settings of these reported cases to aid in [...] Read more.
Background: Since the advent of global COVID-19 vaccination, several studies reported cases of encephalitis with its various subtypes following COVID-19 vaccinations. In this regard, we conducted a systematic review to investigate and characterize the clinical settings of these reported cases to aid in physician awareness and proper care provision. Methods: We systematically searched PubMed, Web of Science, and Scopus and manually searched Google Scholar. Studies published until October 2022 were included. Demographic data, clinical features, vaccine data, treatment lines, and outcomes were extracted. Results: A total of 65 patients from 52 studies were included. The mean age of patients was 46.82 ± 19.25 years, 36 cases (55.4%) were males. AstraZeneca was the most-reported vaccine associated with encephalitis (38.5%) followed by Pfizer (33.8%), Moderna (16.9%), and others. Moat encephalitis cases occurred after the first dose of vaccination in 41/65 (66.1%). The mean time between vaccination and symptom onset was 9.97 ± 7.16 days. Corticosteroids (86.2 %) and immunosuppressants (81.5 %) were the most used lines of treatment. The majority of affected individuals experienced a full recovery. Conclusion: Our study summarizes the current evidence of reported post-vaccination encephalitis, regarding clinical presentation, symptoms onset, management, outcomes, and comorbid conditions; however, it fails to either acknowledge the incidence of occurrence or establish a causal relationship between various COVID-19 vaccines and encephalitis. Full article
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17 pages, 1015 KiB  
Systematic Review
Bell’s Palsy and COVID-19 Vaccines: A Systematic Review and Meta-Analysis
by Khaled Albakri, Abdulrhman Khaity, Hany Atwan, Othman Saleh, Momen Al-Hajali, Shirin Cadri, Rehab Adel Diab, Ebraheem Albazee and Ahmed Negida
Vaccines 2023, 11(2), 236; https://doi.org/10.3390/vaccines11020236 - 20 Jan 2023
Cited by 4 | Viewed by 3933
Abstract
Introduction: Once the COVID-19 pandemic was declared, the world was waiting for the clue that would be able to cut down the progression of the disease. Vaccines play a crucial role in reducing the disease and saving many people worldwide. However, there are [...] Read more.
Introduction: Once the COVID-19 pandemic was declared, the world was waiting for the clue that would be able to cut down the progression of the disease. Vaccines play a crucial role in reducing the disease and saving many people worldwide. However, there are several side effects of these vaccines, like pain, fatigue, fever, and neurological defects like Bell’s palsy. In this systematic review, we presented evidence about the occurrence of Bell’s palsy followed by COVID-19 vaccination. Methods: We searched PubMed, SCOPUS, EBSCO, and Web of Science (WOS) from inception till October 2022. The quality assessment was conducted using the Joanna Briggs Institute, National Institute of Health, and Newcastle-Ottawa. The analysis was conducted on SPSS. Results: Thirty-five records were involved in our study. The results of our cases revealed that most of the patients (62.8%) experienced unilateral facial paralysis. Also, the majority of the cases were reported after the first dose, and most cases were after Pfizer, AstraZeneca, and Sputnik V vaccines, respectively. The patients who were treated with corticosteroids, IVIG, and anti-viral drugs, showed marked recovery afterward. Conclusion: The rate ratio of Bell’s palsy after COVID-19 vaccination was 25.3 per 1,000,000. The ratio was higher after the first dose compared to the second dose and was higher among those who took Oxford/AstraZeneca vaccine compared to other vaccines. However, this condition was reported in a small number of cases among a large number of vaccinated people worldwide. It is important to note that the benefits of getting vaccinated far outweigh any potential risks. Full article
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