Spectrum of Serious Neurological and Psychiatric Adverse Events in Indian COVID‑19 Vaccine Recipients: A Systematic Review of Case Reports and Case Series.

Indian data regarding serious neurological and psychiatric adverse events, following coronavirus disease 2019 (COVID‑19) vaccination, are lacking. We, therefore, systematically evaluated cases of post‑vaccinal serious neurological and psychiatric adverse reactions published from India. A systematic review of cases published from India, which were archived in PubMed, Scopus, and Google Scholar databases, was performed; pre‑print databases along with ahead‑of‑print contents were searched in addition. Retrieved articles, as on June 27, 2022, were evaluated following PRISMA guidelines. EndNote 20 web tool was used to make a PRISMA flow chart. Individual patients’ data were compiled in a tabular form. The protocol of the systematic review was registered with PROSPERO (CRD42022324183). A total of 64 records describing 136 instances of serious neurological and psychiatric adverse events were identified. More than 50% (36/64) reports were from the following four states, namely, Kerala, Uttar Pradesh, New Delhi, and West Bengal. The mean age of persons developing these complications was 44.89 ± 15.77 years. In the majority, adverse events occurred within 2 weeks of administration of the first dose of COVISHIELD vaccine. Immune‑mediated central nervous system (CNS) disorders were identified in 54 instances. Guillain‑Barre syndrome and other immune‑mediated peripheral neuropathies were reported in 21 cases. Post‑vaccinal herpes zoster was recorded in 31 vaccine recipients. Psychiatric adverse events were recorded in six patients. In Indian recipients of COVID‑19 vaccine, a variety of serious neurological complications were reported. The overall risk appears minuscule. Immune‑mediated central and peripheral neuronal demyelinations were the most frequently reported post‑vaccinal adverse events. A large number of cases of herpes zoster have also been reported. Immune‑mediated disorders responded well to immunotherapy. [ABSTRACT FROM AUTHOR]