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J Neurol . Neurological symptoms after COVID-19 vaccination: a report on the clinical presentation of the first 50 patients

tetano

Editor, Senior Moderator
J Neurol


. 2023 Jul 29.
doi: 10.1007/s00415-023-11895-9. Online ahead of print. Neurological symptoms after COVID-19 vaccination: a report on the clinical presentation of the first 50 patients

Ameli Gerhard[SUP] 1 [/SUP], Vanessa Raeder[SUP] 1 [/SUP], Helena Franziska Pernice[SUP] 1 [/SUP], Fabian Boesl[SUP] 1 [/SUP], Maria Schroeder[SUP] 1 [/SUP], Jonathan Richter[SUP] 1 [/SUP], Matthias Endres[SUP] 1 2 3 4 5 [/SUP], Harald Prüß[SUP] 1 3 [/SUP], Katrin Hahn[SUP] 1 6 [/SUP], Heinrich J Audebert[SUP] 1 2 [/SUP], Christiana Franke[SUP] 7 [/SUP]



Affiliations
Abstract

Objectives: Neurological symptoms associated with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) vaccination were discovered in the context of billions of administered vaccine doses. The clinical manifestations often resemble post Coronavirus Disease 2019 (post-COVID-19) syndrome (PCS) features and may be considered as post-COVID-19 vaccine syndrome (PVS). Data regarding frequency, severity and pathophysiological mechanisms are scarce.
Methods: We assessed routine clinical examinations in 50 patients reporting new-onset neurological symptoms after SARS-CoV-2 vaccination, including neurological examination, laboratory and electrophysiology tests, as well as self-report questionnaires measuring fatigue, depressive symptoms, anxiety, risk of somatic symptom disorder, and health-related quality of life. Patients were included when symptoms occurred after confirmed COVID-19 vaccination and without prior SARS-CoV-2 infection, and if no alternative diagnosis was found to explain the symptoms.
Results: The most frequently reported symptoms were paraesthesia (56%), fatigue (46%) and cognitive impairment (36%). Neurological, routine laboratory, and electrophysiological examinations did not yield distinct pathological findings. Neuropsychological testing of a subgroup revealed deficits in attention, executive function and memory.
Discussion: The spectrum of clinical manifestations post-vaccination poses a substantial overlap with PCS symptoms. As no pathological findings were obtained in routine diagnostics, uncertainty remains about the underlying pathophysiological mechanisms and requires further investigation beyond routine work-up.

Keywords: Cognitive impairment; Fatigue; Paresthesia; Post-COVID-19 syndrome (PCS); Post-COVID-19 vaccine syndrome (PVS); SARS-CoV-2 vaccination.

 
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