Neurological and neuropsychological adverse effects of SARS-CoV-2 vaccines - where do we stand?

Anti-N-methyl D-aspartate Receptor Encephalitis Following ChAdOx1 nCoV-19 Vaccination: A Case Report

As of December 2020, millions of people have been immunized using vaccines against SARS-CoV-2. A wide range of neurological adverse effects of SARS-CoV-2 vaccines have been reported so far. Here, we report a 23-year-old male who experienced psychiatric symptoms, loss of consciousness, language disintegration, and incontinency that happened 10 days after the first dosage of the COVID-19 AstraZeneca vaccine. Anti-NMDAR Encephalitis was diagnosed based on the results of the autoimmune panel. The patient responded to intravenous dexamethasone very well and experienced no other complications in 6 months of follow-up. Scientific reports of neurological side effects such as anti-NMDAR encephalitis after vaccination are necessary to optimize the safety and effectiveness of SARS-CoV-2 vaccines.

Observational Study of Patients Hospitalized With Neurologic Events After SARS-CoV-2 Vaccination, December 2020-June 2021

Background and Objectives

The global spread of the COVID-19 pandemic accelerated the vaccine development time line, regulatory approval, and widespread implementation in the population underscoring the importance of postauthorization/postlicensure vaccine safety surveillance. To monitor for vaccine-related adverse events, we prospectively identified patients hospitalized for prespecified neurologic conditions who received mRNA or adenovirus COVID-19 vaccines and assessed cases for potential risk factors and alternative etiologies of the adverse event.

Methods

We identified prespecified neurologic conditions in hospitalized individuals within 6 weeks of receipt of a dose of any COVID-19 vaccination between December 11, 2020, and June 22, 2021 (Columbia University Irving Medical Center/New York Presbyterian Hospital, New York City, New York). Clinical data from electronic medical records in these vaccinated patients were reviewed for assessment of contributing risk factors and etiologies for these neurologic conditions by use of a published algorithm.

Results

Among 3,830 individuals screened for COVID-19 vaccination status and neurologic conditions, 138 (3.6%) cases were included in this study (126 after mRNA and 6 after Janssen vaccines). The 4 most prevalent neurologic syndromes included ischemic stroke (52, 37.7%), encephalopathy (45, 32.6%), seizure (22, 15.9%), and intracranial hemorrhage (ICH) (13, 9.4%). All 138 cases (100%) had 1 or more risk factors and/or evidence for established causes. Metabolic derangement was the most common etiology for seizures (24, 53.3%) and encephalopathy (5, 22.7%) while hypertension was the most significant risk factor in ischemic stroke (45, 86.5%) and ICH cases (4, 30.8%).

Discussion

All cases in this study were determined to have at least 1 risk factor and/or known etiology accounting for their neurologic syndromes. Our comprehensive clinical review of these cases supports the safety of mRNA COVID-19 vaccines.

Incidence and clinical characteristics of adverse neurological events and stroke-like syndrome associated with immune stress-related response after COVID-19 vaccination in 2021 from Thailand

OBJECTIVES

AEFIs (adverse events following immunizations), especially ISRR ( immune stress related response) which can cause stroke-like symptoms may affect the vaccine roll-out campaign to prevent the coronavirus 2019 outbreak.

METHODS

This study aimed to describe the incidence and clinical characteristics of neurological AEFIs and stroke-like symptoms associated with ISRR after COVID-19 vaccination. Characteristics of ISRR were compared to minor ischemic stroke patients during the same period of the study. During March to September 2021, we retrospectively collected data of participants aged ≥ 18 years who received COVID-19 vaccine and developed AEFIs from Thammasat university vaccination center (TUVC). Data of neurological AEFIs patients and minor ischemic stroke patients were collected from hospital electronic medical record system.

RESULTS

COVID-19 vaccine were administered at TUVC for 245,799 doses. AEFIs were reported in 129,652 instances (52.6%). ChADOx-1 nCoV-19 viral vector vaccine has the most frequent occurrence of AEFIs (58.0%), and neurological AEFIs (12.6%). 83% of neurological AEFI was headache. Most were mild and did not need medical attention. Of 119 patients who received COVID-19 vaccine from anywhere with neurological AEFIs and presented to TUH, ISRR was diagnosed in 107 patients (89.9%) and all patients who has follow-up data (30.8%) showed clinical improvement. In comparison with minor ischemic stroke (116 patients), ISRR patients had significantly less ataxia, facial weakness, weakness of arm/leg and speech disturbances (P < 0.001).

CONCLUSION

The incidence of neurological AEFIs after COVID-19 vaccination was higher among recipients of ChAdOx-1 nCoV-19 vaccine (12.6%) than inactivated vaccine (6.2%) and mRNA vaccine (7.5%). However, most neurological AEFIs were ISRR, had mild severity and resolved within 30 days. Stroke-like symptoms occurred less frequently than patients with minor ischemic stroke.

[Neurological complications after covid-19 vaccination]

The aim of our work was to study the relevance and incidence of neurological post-vaccination complications during the COVID-19 pandemic. Based on the results of a systematic literature search of several databases, the current review describes the diagnosed complications, including neurological, that occurred after the administration of the COVID-19 vaccine during the pandemic period. To fully establish the pathophysiological mechanisms of the development of a causal relationship of neurological complications with vaccines against COVID-19, it becomes necessary to continue long-term studies. This will make it possible to carry out a pharmacological correction of the quality of vaccine safety.

Computer assisted identification of stress, anxiety, depression (SAD) in students: A state-of-the-art review

Stress, depression, and anxiety are a person's physiological states that emerge from various body features such as speech, body language, eye contact, facial expression, etc. Physiological emotion is a part of human life and is associated with psychological activities. Sad emotion is relatable to negative thoughts and recognized in three stages containing stress, anxiety, and depression. These stages of Physiological emotion show various common and distinguished symptoms. The present study explores stress, depression, and anxiety symptoms in student life. The study reviews the psychological features generated through various body parts to identify psychological activities. Environmental factors, including a daily routine, greatly trigger psychological activities. The psychological disorder may affect mental and physical health adversely. The correct recognition of such disorder is expensive and time-consuming as it requires accurate datasets of symptoms. In the present study, an attempt has been made to investigate the effectiveness of computerized automated techniques that include machine learning algorithms for identifying stress, anxiety, and depression mental disorder. The proposed paper reviews the machine learning-based algorithms applied over datasets containing questionnaires, audio, video, etc., to recognize sad details. During the review process, the proposed study found that artificial intelligence and machine learning techniques are well recommended and widely utilized in most of the existing literature for measuring psychological disorders. The various machine learning-based algorithms are applied over datasets containing questionnaires, audio, video, etc., to recognize sad details. There has been continuous monitoring for the body symptoms established in the various existing literature to identify psychological states. The present review reveals the study of excellence and competence of machine learning techniques in detecting psychological disorders' stress, depression, and anxiety parameters. This paper shows a systematic review of some existing computer vision-based models with their merits and demerits.

Safety after BBIBP-CorV (Sinopharm) COVID-19 Vaccine in Adolescents Aged 10-17 Years in Thailand

Coronavirus disease 2019 affected child health and impacted learning because of the resulting onsite school closures. This prospective cohort study included children aged 10-17 who received two 4 µg doses of BBIBP-CorV administered intramuscularly 21-28 days apart. To assess vaccine safety, 36,808 participants were then followed with paper- and web-based online questionnaire surveys that captured local and systemic reactogenicities following vaccine administration on days 1, 7, and 30. Among participants, 76% (27,880) reported reactogenicity within the first 24 h and 7 days following the first dose. Half (51.41%) of participants experienced pain at the injection site; the majority of cases were mild in severity. Injection site tenderness (37.93%) was another common local reaction. Fatigue (37.89%), myalgia (33.56%), and headache (26.76%) were the most common systemic reactions. On days 2-7 after the first dose, 25.85% of participants experienced adverse reactions. Following the second dose, reactogenicity was 7.6% and 1.09% within 24 h and between days 2-7. The majority of reactions were of mild to moderate severity. We report that two doses of the BBIBP-CorV caused mild to moderate side effects in adolescents in Thailand. The findings confirm the vaccine's safety profile in this age group.

A bibliometric analysis of COVID-19 publications in neurology by using the visual mapping method

Background

The characteristic symptom of coronavirus disease 2019 (COVID-19) is respiratory distress, but neurological symptoms are the most frequent extra-pulmonary symptoms. This study aims to explore the current status and hot topics of neurology-related research on COVID-19 using bibliometric analysis.

Methods

Publications regarding neurology and COVID-19 were retrieved from the Web of Science Core Collection (WoSCC) on March 28 2022. The Advanced search was conducted using “TS = (‘COVID 19’ or ‘Novel Coronavirus 2019’ or ‘Coronavirus disease 2019’ or ‘2019-nCOV’ or ‘SARS-CoV-2’ or ‘coronavirus-2’) and TS = (‘neurology’or ‘neurological’ or ‘nervous system’ or ‘neurodegenerative disease’ or ‘brain’ or ‘cerebra’ or ‘nerve’)”. Microsoft Excel 2010 and VOSviewer were used to characterize the largest contributors, including the authors, journals, institutions, and countries. The hot topics and knowledge network were analyzed by CiteSpace and VOSviewer.

Results

A total of 5,329 publications between 2020 and 2022 were retrieved. The United States, Italy, and the United Kingdom were three key contributors to this field. Harvard Medical School, the Tehran University of Medical Sciences, and the UCL Queen Square Institute of Neurology were the major institutions with the largest publications. Josef Finsterer from the University of São Paulo (Austria) was the most prolific author. Tom Solomon from the University of Liverpool (UK) was the most cited author. Neurological Sciences and Frontiers in Neurology were the first two most productive journals, while Journal of Neurology held the first in terms of total citations and citations per publication. Cerebrovascular diseases, neurodegenerative diseases, encephalitis and encephalopathy, neuroimmune complications, neurological presentation in children, long COVID and mental health, and telemedicine were the central topics regarding the neurology-related research on COVID-19.

Conclusion

Neurology-related research on COVID-19 has attracted considerable attention worldwide. Research topics shifted from “morality, autopsy, and telemedicine” in 2020 to various COVID-19-related neurological symptoms in 2021, such as “stroke,” “Alzheimer's disease,” “Parkinson's disease,” “Guillain–Barre syndrome,” “multiple sclerosis,” “seizures in children,” and “long COVID.” “Applications of telemedicine in neurology during COVID-19 pandemic,” “COVID-19-related neurological complications and mechanism,” and “long COVID” require further study.