Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection

Emerging reports of rare neurological complications associated with COVID-19 infection and vaccinations are leading to regulatory, clinical and public health concerns. This study investigated hospital admissions from neurological complications in the 28 days after a first dose of ChAdOx1nCoV-19 (n=20,417,752) or BNT162b2 (n=12,134,782) vaccines, and after a SARS-CoV-2-positive test (n = 2,005,280). Increased risks of Guillain-Barré syndrome and Bell's palsy were associated with ChAdOx1nCoV-19, while hemorrhagic stroke risk was increased with BNT162b2. SARS-CoV-2 infection showed a substantially higher risk of all neurological outcomes. While neurological complications are increased with COVID-19 vaccines, the risk is greater following SARS-CoV-2 infection.

Martina Patone, Lahiru Handunnetthi, Defne Saatci, Jiafeng Pan, Srinivasa Vittal Katikireddi, Saif Razvi, David Hunt, Xue W. Mei, Sharon Dixon, Francesco Zaccardi, Kamlesh Khunti, Peter Watkinson, Carol A. C. Coupland, James Doidge, David A. Harrison, Rommel Ravanan, Aziz Sheikh, Chris Robertson, Julia Hippisley-Cox