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Título

NEUROLOGICAL COMPLICATIONS POST-VACCINATION AGAINST SARS-COV-2: A CASE SERIES FROM NORTHEASTERN BRAZIL

Resumo

Introduction: The SARS-CoV-2 virus caused the coronavirus disease pandemic in mid-2020 with millions of deaths, which led to an urgency in the development of vaccines against the virus. Neurological complications resulting from vaccination against SARS-CoV-2 are increasingly evident worldwide and require further clinical investigation. Vaccination-related neurological manifestations are rare but already reported for other vaccines, such as Guillain-Barré syndrome after influenza vaccination.
Objective: To describe the clinical presentation of sixteen cases of patients exhibiting neurological manifestation after SARS-CoV-2 vaccination.
Methodology: This is a case series report nested within the Brazilian multicenter case-control NeuroCOVID study (Fiocruz-PE). Sixteen adult patients with neurological manifestations referred to Hospital da Restauração (Recife, Pernambuco, Brazil) in 2021 were studied. Physical examination, imaging test (when necessary), and laboratory tests were performed. All the patients (or legal representatives) signed the study consent form.
Results and Conclusion: Most of the patients were of the female gender (10/16) and the median age was 63.5 years (mean ± SD = 58.25 ± 21.03 years). Of the sixteen patients, eleven patients were vaccinated with an adenoviral vector-based vaccine encoding the spike glycoprotein of SARS CoV-2 (ChAdOx1 nCov-19, Oxford/AstraZeneca/Fiocruz), and six individuals received the inactivated virus-based vaccine (Sinovac/Coronavac/Butantan). The delirium-associated encephalopathy was the major neurological manifestation among the patients (4/16), followed by optic neuritis (3/16), and headache/migraine (2/16). Other neurologic complications were benign paroxysmal vertigo, ischemic stroke, encephalitis, Guillain-Barré syndrome, myasthenia gravis, sixth nerve neuritis, and transverse myelitis. The interval between the vaccine dose and the onset of the symptoms varied from zero to ninety-five days. These cases had no other cause associated with the neurological diagnosis and were reported to the government surveillance system. Moreover, our study team is part of the Expert Committee on Adverse Events of the COVID-19 vaccine of the Pernambuco State Health Department. The notification and evaluation of these cases are of great importance for a better understanding of the clinical picture and management of the patients. Financial Support: Fiocruz-PE.

Palavras Chave

Neurological complication; Vaccination; SARS-CoV-2; COVID-19.