Post COVID-19 Vaccination-Associated Neurological Complications

Area of Science:

• Neurology
• Immunology
• Public Health

Background:

• Neurological sequelae following COVID-19 vaccination are infrequent.
• Understanding the pathogenesis of these rare events is crucial for vaccine safety monitoring.

Purpose of the Study:

• To investigate the potential pathogenesis of neurological complications occurring shortly after COVID-19 vaccination in Saudi residents.
• To analyze clinical presentations, radiological findings, and laboratory results of patients experiencing neurological issues post-vaccination.

Main Methods:

• Evaluation of 18 patients presenting with neurological complications after receiving COVID-19 vaccines (Comirnaty, Vaxzevria).
• Assessment included neurological examination, imaging studies, and laboratory investigations.
• Focus on patients from Saudi German Hospitals in Jeddah, Saudi Arabia.

Main Results:

• Three cases of severe cerebral venous thrombosis (CVT) with intracranial hemorrhage occurred after Vaxzevria vaccination, associated with high d-dimers and thrombocytopenia.
• Ischemic stroke was observed in 8 patients (44.4%), predominantly older males.
• Other reported complications included seizures, optic neuritis, Guillain-Barré syndrome (GBS), and Miller Fisher syndrome (MFS).

Conclusions:

• Neurological complications post-COVID-19 vaccination are exceedingly rare, potentially linked to a vaccine-induced hypercoagulable state.
• COVID-19 vaccine-associated ischemic stroke may respond better to treatment compared to infection-induced stroke.
• While a definitive link between COVID-19 vaccines and GBS is not strongly proven, it's a noted rare side effect; MFS is reported here for the first time post-vaccination.