期刊
NATURE MEDICINE
卷 27, 期 12, 页码 2144-+出版社
NATURE PORTFOLIO
DOI: 10.1038/s41591-021-01556-7
关键词
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资金
- National Institute for Health Research (NIHR) Biomedical Research Centre, Oxford
- John Fell Oxford University Press Research Fund
- Cancer Research UK (CR-UK) [C5255/A18085]
- Cancer Research UK Oxford Centre
- Oxford Wellcome Institutional Strategic Support Fund [204826/Z/16/Z]
- UK Research and Innovation [MC_PC_20029]
- National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands
- NIHR Lifestyle BRC
- NRS Senior Clinical Fellowship [SCAF/15/02]
- UK Medical Research Council [MC_UU_00022/2]
- Scottish Government Chief Scientist Office [SPHSU17]
- NIHR-funded clinical lectureship [CL-2019-13-001]
- Office For National Statistics
Emerging reports of rare neurological complications associated with COVID-19 infection and vaccinations are leading to concerns in regulatory, clinical, and public health sectors. A self-controlled case series study in England showed an increased risk of rare neurological complications following COVID-19 vaccination and infection. The study highlighted a higher risk of Guillain-Barre syndrome after ChAdOx1nCoV-19 vaccination.
Emerging reports of rare neurological complications associated with COVID-19 infection and vaccinations are leading to regulatory, clinical and public health concerns. We undertook a self-controlled case series study to investigate 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), and after a SARS-CoV-2-positive test (n = 2,005,280). There was an increased risk of Guillain-Barre syndrome (incidence rate ratio (IRR), 2.90; 95% confidence interval (CI): 2.15-3.92 at 15-21 days after vaccination) and Bell's palsy (IRR, 1.29; 95% CI: 1.08-1.56 at 15-21 days) with ChAdOx1nCoV-19. There was an increased risk of hemorrhagic stroke (IRR, 1.38; 95% CI: 1.12-1.71 at 15-21 days) with BNT162b2. An independent Scottish cohort provided further support for the association between ChAdOx1nCoV and Guillain-Barre syndrome (IRR, 2.32; 95% CI: 1.08-5.02 at 1-28 days). There was a substantially higher risk of all neurological outcomes in the 28 days after a positive SARS-CoV-2 test including Guillain-Barre syndrome (IRR, 5.25; 95% CI: 3.00-9.18). Overall, we estimated 38 excess cases of Guillain-Barre syndrome per 10 million people receiving ChAdOx1nCoV-19 and 145 excess cases per 10 million people after a positive SARS-CoV-2 test. In summary, although we find an increased risk of neurological complications in those who received COVID-19 vaccines, the risk of these complications is greater following a positive SARS-CoV-2 test. A self-controlled case series analysis of nearly 32 million people in England shows an increased risk of rare neurological complications in those who received COVID-19 vaccines and following SARS-CoV-2 infection. The results highlight 38 excess cases of Guillain-Barre syndrome per 10 million ChAdOx1nCoV-19 vaccinations.
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