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Merino D, Gérard AO, Van Obberghen EK, Ben Othman N, Ettore E, Giordana B, Viard D, Rocher F, Destere A, Benoit M, Drici MD. COVID-19 Vaccine-Associated Transient Global Amnesia: A Disproportionality Analysis of the WHO Safety Database. Front Pharmacol 2022; 13:909412. [PMID: 35668936 PMCID: PMC9164011 DOI: 10.3389/fphar.2022.909412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/02/2022] [Indexed: 11/24/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) spread rapidly, resulting in a global pandemic for which vaccines were quickly developed. As their safety continues to be monitored, cases of transient global amnesia (TGA) following mRNA vaccination with elasomeran have been reported. TGA is characterized by sudden onset of anterograde amnesia with preservation of other cognitive functions and resolution within 24 h. We aimed to investigate the potential link of TGA with COVID-19 vaccines. We queried the World Health Organization VigiBase® for all reports of "Transient global amnesia", up to 6 December 2021. Disproportionality analysis relied on the Reporting Odds Ratio (ROR) with its 95% Confidence Interval (CI) and the Information Component (IC). A positive lower end of the 95% CI of the IC (IC025) is used to statistically detect a signal. Of all TGA cases, 289 were associated with a COVID-19 vaccine, representing the most frequent association. Tozinameran was mostly represented (147, 50.8%), followed by AZD1222 (69, 23,8%), elasomeran (60, 20.8%), and JNJ-78436735 (12, 4.2%). With an IC025 > 0, COVID-19 vaccines showed a significant ROR (5.1; 95%CI 4.4-6.0). Tozinameran reached the strongest ROR (4.6; 95%CI 3.9-5.0), followed by elasomeran (4.4; 95%CI 3.4-6.0), AZD1222 (3.8; 95%CI 3.0-5.0), and JNJ-78436735 (3.7; 95%CI 2.1-6.0). Our analysis of COVID-19 vaccines-related TGA reports shows significant disproportionality. Cerebrovascular, inflammatory, or migrainous mechanisms may underlie this association. Yet, numerous confounding factors cannot be tackled with this approach, and causality cannot be ascertained. The identification of this trigger of TGA may help the clinician in his etiological research.
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Affiliation(s)
- Diane Merino
- Department of Psychiatry, University Hospital of Nice, Nice, France
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
| | - Alexandre O. Gérard
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
- Department of Nephrology-Dialysis-Transplantation, University Hospital of Nice, Nice, France
| | | | - Nouha Ben Othman
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
| | - Eric Ettore
- Department of Psychiatry, University Hospital of Nice, Nice, France
| | - Bruno Giordana
- Department of Psychiatry, University Hospital of Nice, Nice, France
| | - Delphine Viard
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
| | - Fanny Rocher
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
| | - Alexandre Destere
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
| | - Michel Benoit
- Department of Psychiatry, University Hospital of Nice, Nice, France
| | - Milou-Daniel Drici
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital of Nice, Nice, France
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Seidling HM, Lampert A, Lohmann K, Schiele JT, Send AJF, Witticke D, Haefeli WE. Safeguarding the process of drug administration with an emphasis on electronic support tools. Br J Clin Pharmacol 2013; 76 Suppl 1:25-36. [PMID: 24007450 DOI: 10.1111/bcp.12191] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 03/20/2013] [Indexed: 12/24/2022] Open
Abstract
AIMS The aim of this work is to understand the process of drug administration and identify points in the workflow that resulted in interventions by clinical information systems in order to improve patient safety. METHODS To identify a generic way to structure the drug administration process we performed peer-group discussions and supplemented these discussions with a literature search for studies reporting errors in drug administration and strategies for their prevention. RESULTS We concluded that the drug administration process might consist of up to 11 sub-steps, which can be grouped into the four sub-processes of preparation, personalization, application and follow-up. Errors in drug handling and administration are diverse and frequent and in many cases not caused by the patient him/herself, but by family members or nurses. Accordingly, different prevention strategies have been set in place with relatively few approaches involving e-health technology. CONCLUSIONS A generic structuring of the administration process and particular error-prone sub-steps may facilitate the allocation of prevention strategies and help to identify research gaps.
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Affiliation(s)
- Hanna M Seidling
- Department of Clinical Pharmacology and Pharmacoepidemiology, Medizinische Klinik, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
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Abstract
Transient global amnesia (TGA) is a transitory syndrome of memory loss, lasting less than 24 h. Although there are many known causes of transient amnesia, the syndrome of TGA remains of unknown etiology. Known causes of transient amnesia, theories of pathogenesis of TGA, and recommended evaluation and treatment are discussed.
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Affiliation(s)
- Howard S Kirshner
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
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