New evidence suggests there may be an increased risk of neurological complications following SARS-CoV-2 infection and COVID-19 vaccination

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According to an article published in Nature Medicine, there is an increased risk of neurological complications in those receiving COVID-19 vaccines, although this risk is much higher following SARS-CoV-2 infection.

The analysis included 20,417,752 individuals who received ChAdOx1 nCoV-19 (AstraZeneca) COVID-19 vaccine, 12,134,782 who received BNT162b2 (Pfizer–BioNTech), and 2,005,280 who had a positive SARS-CoV-2 test. Hospital admissions for neurological complications in the 28 days following the first dose of either vaccine or a positive SARS-CoV-2 test were investigated.

There was an increased risk of Guillain-Barré syndrome and Bell’s palsy after receiving ChAdOx1 nCoV-19, with an incidence rate ratio (IRR) of 2.90 and 1.29, respectively. With BNT162b2, there was an increased risk of haemorrhagic stroke (IRR 1.38). The risk of all neurological outcomes was substantially higher in the 28 days after a positive SARS-CoV-2 test, including Guillain-Barré syndrome (IRR 5.25).

With ChAdOx1 nCoV-19, there were 38 excess Guillain-Barré syndrome events per 10 million people vaccinated. For BNT1262b2, there were 60 extra cases of haemorrhagic stroke per 10 million people vaccinated. For SARS-CoV-2 infection, there were an estimated 123 additional events of encephalitis, meningitis, and myelitis, and 145 cases of Guillain-Barré syndrome per 10 million people with a positive test.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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