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Neurological manifestations of immune origin after COVID-19 vaccination: retrospective case study.

Authors :
Granja López J
Estebas Armas C
Lorenzo Dieguez M
Puertas Muñoz I
De Celis Ruiz E
Rigual R
Fernández-Fournier M
Torres Iglesias G
Sánchez Velasco S
Tallón Barranco A
Rogozina O
Ramírez E
González-Muñoz M
Lacruz Ballester L
Source :
Frontiers in pharmacology [Front Pharmacol] 2024 Aug 08; Vol. 15, pp. 1376474. Date of Electronic Publication: 2024 Aug 08 (Print Publication: 2024).
Publication Year :
2024

Abstract

Objectives: To know the frequency and characteristics of neurological manifestations of probable immune origin occurring after exposure to COVID-19 vaccination. In addition, to pre-study the usefulness of the Spanish pharmacovigilance system and lymphocyte transformation test in establishing causality. Methods: Retrospective case study, including patients admitted to the Neurology department from January 2021 to May 2022 with a probable neuroimmune disorder. Demographic, clinical and COVID-19 vaccination antecedent data were collected from medical records. Results: From a total of 108 patients, 30 were excluded due to a different etiological diagnosis after follow-up. Thirty-six patients (46.2%) had received the COVID-19 vaccine in the previous 3 months (21.8% during the previous month). BioNTech-Pfizer vaccine was the most frequent in this group (63.9%). 69/108 were female and mean age 51.2 years (SD 22.59), with no significant difference with not recently-vaccinated (U-Mann Whitney, p = 0.256). The neurological syndromes found were (vaccinated/total): polyradiculoneuropathy (8/16), encephalitis (5/11), multiple sclerosis relapse (5/16), optic neuritis (1/4), myelitis (3/6), cranial neuropathy (6/10), aseptic meningitis (1/3) and others (7/11). Acute immunosuppressive treatment was administered in 61.1% of cases and 47.2% presented complete clinical improvement, without significant differences with non-vaccinated patients (chi-square, p = 0.570). Eleven vaccinated patients were studied in the pharmacovigilance office for possible adverse drug reaction. Causality according to the Spanish pharmacovigilance system (SPVS) algorithm was "Related" to COVID-19 vaccine (score ≥ 4) in 11 cases with positive in vitro study (lymphocyte transformation test) to polyethylene glycol-2000 and polysorbate-80 in 4 cases. Conclusion: Neuroimmune disorders appearing after administration of COVID-19 vaccine do not seem to present important differentiating clinical and/or evolutive features. Delayed hypersensitivity to vaccine excipients could be one of the pathophysiological mechanisms, and lymphocyte transformation test is a useful tool to identify it.<br />Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.<br /> (Copyright © 2024 Granja López, Estebas Armas, Lorenzo Dieguez, Puertas Muñoz, De Celis Ruiz, Rigual, Fernández-Fournier, Torres Iglesias, Sánchez Velasco, Tallón Barranco, Rogozina, Ramírez, González-Muñoz and Lacruz Ballester.)

Details

Language :
English
ISSN :
1663-9812
Volume :
15
Database :
MEDLINE
Journal :
Frontiers in pharmacology
Publication Type :
Academic Journal
Accession number :
39175548
Full Text :
https://doi.org/10.3389/fphar.2024.1376474