Co-VAN study: COVID-19 vaccine associated neurological diseases- an experience from an apex neurosciences centre and review of the literature

M M Samim; Debjyoti Dhar; Faheem Arshad; D D S Anudeep; Vishal G Patel; Sriram Ramalakshmi Neeharika; Kamakshi Dhamija; Chowdary Mundlamuri Ravindranath; Ravi Yadav; Pritam Raja; M Netravathi; Deepak Menon; Vikram V Holla; Nitish L Kamble; Pramod K Pal; Atchayaram Nalini; Seena Vengalil

doi:10.1016/j.jocn.2022.12.015

Co-VAN study: COVID-19 vaccine associated neurological diseases- an experience from an apex neurosciences centre and review of the literature

J Clin Neurosci. 2023 Feb:108:37-75. doi: 10.1016/j.jocn.2022.12.015. Epub 2022 Dec 23.

Authors

M M Samim¹, Debjyoti Dhar¹, Faheem Arshad¹, D D S Anudeep¹, Vishal G Patel¹, Sriram Ramalakshmi Neeharika¹, Kamakshi Dhamija¹, Chowdary Mundlamuri Ravindranath¹, Ravi Yadav¹, Pritam Raja¹, M Netravathi¹, Deepak Menon¹, Vikram V Holla¹, Nitish L Kamble¹, Pramod K Pal¹, Atchayaram Nalini¹, Seena Vengalil²

Affiliations

¹ Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India.
² Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India. Electronic address: seenavengalil@gmail.com.

Abstract

Background: Recent studies have shown various neurological adverse events associated with COVID-19 vaccine.

Objective: We aimed to retrospectively review and report the neurological diseases temporally associated with COVID-19 vaccine.

Methods: We performed a retrospective chart review of admitted patients from 1st February 2021 to 30th June 2022. A total of 4672 medical records were reviewed of which 51 cases were identified to have neurological illness temporally associated with COVID-19 vaccination.

Results: Out of 51 cases, 48 had probable association with COVID-19 vaccination while three had possible association. Neurological spectrum included CNS demyelination (n = 39, 76.5 %), Guillain-Barré-syndrome (n = 3, 5.9 %), stroke (n = 6, 11.8 %), encephalitis (n = 2, 3.9 %) and myositis (n = 1, 2.0 %). Female gender had a greater predisposition (F:M, 1.13:1). Neurological events were more commonly encountered after the first-dose (n = 37, 72.5%). The mean latency to onset of symptoms was 13.2 ± 10.7 days after the last dose of vaccination. COVIShield (ChAdOx1) was the most commonly administered vaccine (n = 43, 84.3 %). Majority of the cases with demyelination were seronegative (n = 23, 59.0 %) which was followed by anti-Myelin oligodendrocyte-glycoprotein associated demyelination (MOGAD) (n = 11, 28.2 %) and Neuromyelitis optica (NMOSD) (n = 5, 12.8 %). Out of 6 Stroke cases, 2 cases (33.3 %) had thrombocytopenia and coagulopathy. At discharge, 25/51 (49.0 %) of the cases had favourable outcome (mRS 0 to 1). Among six patients of stroke, only one of them had favourable outcome.

Conclusion: In this series, we describe the wide variety of neurological syndromes temporally associated with COVID-19 vaccination. Further studies with larger sample size and longer duration of follow-up are needed to prove or disprove causality association of these syndromes with COVID-19 vaccination.

Keywords: AEFI; COVID19; COVID19 vaccination; SARS-CoV2 vaccine; Vaccine side effect.

Publication types

Review

MeSH terms

COVID-19 Vaccines / adverse effects
COVID-19* / prevention & control
ChAdOx1 nCoV-19
Humans
Nervous System Diseases* / etiology
Neuromyelitis Optica*
Retrospective Studies
Stroke*

Substances

ChAdOx1 nCoV-19
COVID-19 Vaccines