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Abuawwad MT, Taha MJJ, Taha AJ, Kozaa YA, Falah O, Abuawwad IT, Hammad EM, Mahmoud AA, Aladawi M, Serhan HA. Guillain-Barré syndrome after COVID-19 vaccination: A systematic review and analysis of case reports. Clin Neurol Neurosurg 2024; 238:108183. [PMID: 38401232 DOI: 10.1016/j.clineuro.2024.108183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 02/26/2024]
Abstract
INTRODUCTION Cases of Guillain-Barré Syndrome (GBS) have been believed to be associated with the novel COVID-19 infection, and also with the following vaccines developed against the infection. Our work aims to investigate the incidence of GBS after COVID-19 vaccination, and describe its clinical characteristics and potential confounders. METHODS An electronic search was conducted through four databases: PubMed, Scopus, medRxiv, and Google Scholar for all case reports and case series describing after COVID-19 vaccine administration. All published articles from inception until November 1st, 2022 were included. Differences between groups were assessed using Pearson chi-square test. Modified Erasmus GBS Outcome Score (mEGOS) for the ability to walk after GBS was calculated for all cases with sufficient clinical data, and Kaplan-Meier survival analysis was performed to study the effect of vaccine type on the relationship between vaccination time and complication of GBS. RESULTS About 103 studies describing 175 cases of GBS following COVID-19 vaccination were included. The Acute Inflammatory Demyelinating Polyradiculoneuropathy subtype was the most reported subtype with 74 cases (42.29%). The affected age group averaged around 53.59 ±18.83 years, with AMSAN occurring in a rather older group (63.88 ±20.87 years, p=0.049). The AstraZeneca vaccine was associated with AIDP (n=38, 21.71%) more than other vaccines, p=0.02. The bilateral facial palsy subtype was mostly linked to adenoviral vector vaccinations, accounting for an average of 72% of the total BFP cases. Dysesthesias was the most reported sensory complication (60%, p=0.349). Most GBS patients survived (96%, p=0.036), however, most patients had low mEGOS scores (4 ±3.57, p<0.01). On average, patients developed GBS at 13.43 ±11.45 days from vaccination (p=0.73), and survival analysis for complication of GBS into mechanical ventilation or walking impairment yielded a severely increased probability of complication after 25 days (p<0.01). Intravenous immunoglobulins (p=0.03) along with rehabilitation (p=0.19) were the most commonly used treatment. CONCLUSION This work investigates the incidence of Guillain-Barré Syndrome after COVID-19 vaccination. Most cases occurred after receiving the AstraZeneca or Pfizer vaccines, and despite low mortality rates, ambulation was compromised in most patients. A higher risk of GBS complication is associated with an onset later than 12-13 days, particularly with Pfizer, AstraZeneca, and Moderna vaccines. No specific predisposing or prognostic factor was identified, and the relation between the COVID-19 vaccines and GBS remain unclear.
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Affiliation(s)
- Mohammad T Abuawwad
- Department of Clinical Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohammad J J Taha
- Department of Clinical Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmad J Taha
- Department of Clinical Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Yasmeena Abdelall Kozaa
- Mansoura Manchester Programme For Medical Education, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Obaida Falah
- Department of Clinical Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ibrahim T Abuawwad
- Department of Clinical Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Elsayed Mohamed Hammad
- Department of Clinical Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ayman A Mahmoud
- Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - Mohammad Aladawi
- Department of Neurological Sciences, University of Nebraska Medical Center, Nebraska, USA
| | - Hashem Abu Serhan
- Department of Ophthalmology, Hamad Medical Corporations, Doha, Qatar.
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Ginanneschi F, Vinciguerra C, Volpi N, Piscosquito G, Barone P, Rossi A. Chronic inflammatory demyelinating polyneuropathy after SARS-CoV2 vaccination: update of the literature and patient characterization. Immunol Res 2023; 71:833-838. [PMID: 37395901 DOI: 10.1007/s12026-023-09406-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 06/28/2023] [Indexed: 07/04/2023]
Abstract
Since the beginning of worldwide vaccination against COVID-19 disease, some reports have revealed a possible relationship between SARS CoV2 vaccination and chronic inflammatory demyelinating polyneuropathy (CIDP). We reviewed the available evidences regarding this topic, adding three new cases to those reported so far, with the purpose to outline the characteristics of these post-vaccinal CIDP. Seventeen subjects were studied. A total of 70.6% of CIDP cases were related to viral vector vaccines, most occurring after the administration of the first dose. CIDPs that occurred after the second dose (17%) were temporally associated with mRNA vaccines. The clinical course and electrophysiology of all patients met the criteria for acute-subacute CIDP (A-CIDP). Administration of the viral vector vaccine was significantly correlated with a higher probability of having cranial nerve impairment (p = 0.004). The electrophysiological phenotype, laboratory and imaging data, and first-line therapies were substantially similar to those of the classical CIDP. The take-home message of the present paper is that the SARS CoV2 vaccine, especially the AstraZeneca vaccine, may be associated with inflammatory neuropathies with acute onset, often indistinguishable from Guillain-Barré syndrome (GBS). Hence, the importance of tracked prospectively patients with GBS occurred post-SARS-CoV2 vaccine. Distinguishing GBS from A-CIDP is crucial because treatment strategies and long-term prognosis are different.
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Affiliation(s)
- Federica Ginanneschi
- Neurology and Clinical Neurophysiology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy.
| | - Claudia Vinciguerra
- Neurology Unit, University Hospital "San Giovanni Di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Nila Volpi
- Neurology and Clinical Neurophysiology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - Giuseppe Piscosquito
- Neurology Unit, University Hospital "San Giovanni Di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Paolo Barone
- Neurology Unit, University Hospital "San Giovanni Di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Alessandro Rossi
- Neurology and Clinical Neurophysiology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy
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López-Carriches C, Leco-Berrocal MI, Bahram-Taheri R, Cardona-Moreno C, Cortés-Bretón-Brinkmann J, Moreno-López LA. Neurological complications following mRNA COVID-19 vaccination: Oral and lower limb paresthesia. A case discussion and literature review. J Clin Exp Dent 2023; 15:e866-e869. [PMID: 37933398 PMCID: PMC10625676 DOI: 10.4317/jced.60891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/03/2023] [Indexed: 11/08/2023] Open
Abstract
Vaccines used in the coronavirus pandemic have reported some minor side effects such as pain at the injection site, headache, myalgia and fever. Also major neurological side effects have been experienced by some patients. We present the clinical case of a healthy woman who two weeks after being vaccinated with the third dose of Moderna COVID-19 Vaccine, began to feel numbness in mouth, both feet, legs, interscapular space, and hands. She was diagnosed with distal sensory polyneuropathy caused by the vaccine. Progressive improvement was seen. The patient did not require corticosteroid medication. We reviewed the literature to assess the frequency of this type of complication. Key words:COVID-19, SARS-CoV-2, vaccine, vaccination, peripheral axonal neuropathy, transverse myelitis, oral manifestations.
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Affiliation(s)
- Carmen López-Carriches
- Associate Professor, Department of Dental Clinic Specialties. School of Dentistry, Universidad Complutense de Madrid, Spain
| | - Mª Isabel Leco-Berrocal
- Assistant Professor, Department of Dental Clinical Specialties, School of Dentistry, Universidad Complutense de Madrid, Spain
| | - Ricardo Bahram-Taheri
- Doctor of Dental Surgery. DDS. Collaborator. School of Dentistry, Universidad Complutense de Madrid. Spain
| | - Carlos Cardona-Moreno
- Doctor of Dental Surgery. DDS. Collaborator. School of Dentistry, Universidad Complutense de Madrid. Spain
| | - Jorge Cortés-Bretón-Brinkmann
- Associate Professor, Department of Dental Clinic Specialties. School of Dentistry, Universidad Complutense de Madrid, Spain
| | - Luis-Alberto Moreno-López
- Assistant Professor, Department of Dental Clinical Specialties, School of Dentistry, Universidad Complutense de Madrid, Spain
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Ameer MZ, Haiy AU, Bajwa MH, Abeer H, Mustafa B, Ameer F, Amjad Z, Rehman AU. Association of Parsonage-Turner syndrome with COVID-19 infection and vaccination: a systematic review. J Int Med Res 2023; 51:3000605231187939. [PMID: 37523491 PMCID: PMC10392513 DOI: 10.1177/03000605231187939] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVES The exact etiology of Parsonage-Turner syndrome is unknown, but it is known to be preceded by infection, vaccination, or surgical intervention. In this review, we describe associations of Parsonage-Turner syndrome with COVID-19 infection and vaccination. METHODS A systematic literature search was conducted using PubMed/MEDLINE, ScienceDirect, and Google Scholar. Microsoft Excel was used for data extraction and statistical analysis. The quality of case reports and case series was assessed using the Joanna Briggs Institute Critical Appraisal Tool. RESULTS We selected 44 case reports and 10 case series, including 68 patients (32 post-vaccination and 36 with post-COVID-19 infection Parsonage-Turner syndrome). Middle-aged males were predominantly affected in both groups. The most frequently administered vaccine was Comirnaty (Pfizer) (53%). The mean latency was 11.7 days in the post-vaccination group and 20.3 days in the post-infection group. The most affected nerves in both groups were the axillary, suprascapular, and musculocutaneous nerves; and 78.1% and 38.9% of patients showed partial amelioration of their symptoms in the post-vaccination and post-infection groups, respectively. CONCLUSION Post-vaccination Parsonage-Turner syndrome presents earlier than post-infection disease. Pain and sensorimotor deficits of the upper limb are common in both situations. Complete or partial recovery occurs in most cases.
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Affiliation(s)
| | - Ata Ul Haiy
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | | | - Huzaifa Abeer
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Biah Mustafa
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Fatima Ameer
- Department of Medicine, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | - Zunaira Amjad
- Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | - Aqeeb Ur Rehman
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
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Baltoumas FA, Sofras D, Apostolakou AE, Litou ZI, Iconomidou VA. NucEnvDB: A Database of Nuclear Envelope Proteins and Their Interactions. MEMBRANES 2023; 13:62. [PMID: 36676869 PMCID: PMC9861991 DOI: 10.3390/membranes13010062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
The nuclear envelope (NE) is a double-membrane system surrounding the nucleus of eukaryotic cells. A large number of proteins are localized in the NE, performing a wide variety of functions, from the bidirectional exchange of molecules between the cytoplasm and the nucleus to chromatin tethering, genome organization, regulation of signaling cascades, and many others. Despite its importance, several aspects of the NE, including its protein-protein interactions, remain understudied. In this work, we present NucEnvDB, a publicly available database of NE proteins and their interactions. Each database entry contains useful annotation including a description of its position in the NE, its interactions with other proteins, and cross-references to major biological repositories. In addition, the database provides users with a number of visualization and analysis tools, including the ability to construct and visualize protein-protein interaction networks and perform functional enrichment analysis for clusters of NE proteins and their interaction partners. The capabilities of NucEnvDB and its analysis tools are showcased by two informative case studies, exploring protein-protein interactions in Hutchinson-Gilford progeria and during SARS-CoV-2 infection at the level of the nuclear envelope.
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Affiliation(s)
- Fotis A. Baltoumas
- Section of Cell Biology & Biophysics, Department of Biology, School of Sciences, National & Kapodistrian University of Athens, Panepistimiopolis, 15701 Athens, Greece
- Institute for Fundamental Biomedical Research, Biomedical Sciences Research Center “Alexander Fleming”, 34 Fleming St., 16672 Athens, Greece
| | - Dimitrios Sofras
- Section of Cell Biology & Biophysics, Department of Biology, School of Sciences, National & Kapodistrian University of Athens, Panepistimiopolis, 15701 Athens, Greece
- Laboratory of Molecular Cell Biology, KU Leuven, Kasteelpark Arenberg 31—Box 2438, 3001 Leuven, Belgium
| | - Avgi E. Apostolakou
- Section of Cell Biology & Biophysics, Department of Biology, School of Sciences, National & Kapodistrian University of Athens, Panepistimiopolis, 15701 Athens, Greece
| | - Zoi I. Litou
- Section of Cell Biology & Biophysics, Department of Biology, School of Sciences, National & Kapodistrian University of Athens, Panepistimiopolis, 15701 Athens, Greece
| | - Vassiliki A. Iconomidou
- Section of Cell Biology & Biophysics, Department of Biology, School of Sciences, National & Kapodistrian University of Athens, Panepistimiopolis, 15701 Athens, Greece
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Galassi G, Ariatti A. Comment on "Neuromuscular complications after COVID-19 vaccination: a series of eight patients" by Leemans et al. Acta Neurol Belg 2022:10.1007/s13760-022-02117-6. [PMID: 36273111 PMCID: PMC9589649 DOI: 10.1007/s13760-022-02117-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/11/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Giuliana Galassi
- Department of Biomedical, Metabolic Neural Sciences, University of Modena, Modena, Italy.
| | - Alessandra Ariatti
- Department of Biomedical, Metabolic Neural Sciences, University of Modena, Modena, Italy
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Bilateral Facial Weakness with Distal Paresthesia Following COVID-19 Vaccination: A Scoping Review for an Atypical Variant of Guillain-Barré Syndrome. Brain Sci 2022; 12:brainsci12081046. [PMID: 36009109 PMCID: PMC9406009 DOI: 10.3390/brainsci12081046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/29/2022] [Accepted: 08/04/2022] [Indexed: 12/04/2022] Open
Abstract
Background and Purpose: Recent population-based studies from the US and UK have identified an increase in the occurrence of Guillain–Barré syndrome (GBS) following coronavirus disease 2019 (COVID-19) vaccination. However, the localized variant of GBS might be underestimated due to its rarity and atypical features. We aimed to identify and characterize bilateral facial weakness with distal paresthesia (BFWdp) as a GBS variant following COVID-19 vaccination. Materials and Methods: Relevant studies published during the COVID-19 pandemic were searched and identified in the MEDLINE, Embase, and other databases. Results: This review found that 18 BFWdp cases presented characteristics similar to previous BFWdp cases as defined in the literature: male dominance, frequent albuminocytological dissociation, and acute inflammatory demyelinating neuropathy pattern. In contrast, facial nerve enhancement on brain MRI and antiganglioside antibody positivity were often observed in BFWdp following COVID-19 vaccination. Conclusions: The mechanism of BFWdp following COVID-19 vaccination appears to be somewhat different from that of sporadic BFWdp. Neurological syndromes with rare incidence and difficulty in diagnosis should be considered adverse events of COVID-19 vaccination.
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