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Neuropathic symptoms with SARS-CoV-2 vaccination
Farinaz Safavi1, Lindsey Gustafson1, Brian Walitt1
1National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.
Medrxiv : the Preprint Server for Health Sciences
|May 25, 2022
Summary
Neuropathic symptoms, including sensory and autonomic dysfunction, may occur after COVID-19 vaccination, potentially due to immune responses. Early treatment with corticosteroids or immunoglobulin can improve outcomes in some patients.
Area of Science:
- Neurology
- Immunology
Background:
- Peripheral neuropathies, including sensory and autonomic dysfunction, are known complications of acute COVID-19, often linked to immune dysregulation.
- The occurrence of similar neuropathic manifestations following SARS-CoV-2 vaccination remained unclear.
Approach:
- An observational study investigated 23 patients experiencing neuropathic symptoms within one month post-SARS-CoV-2 vaccination.
- Evaluated symptoms included sensory disturbances (paresthesias) and autonomic dysfunction (orthostasis, heat intolerance).
- Diagnostic methods included autonomic testing, skin biopsies for epidermal neurite density, and evaluation for immune complexes (C4d deposition).
Key Points:
- 52% of patients showed objective evidence of small-fiber peripheral neuropathy.
- Skin biopsies revealed reduced epidermal neurite density and abnormal axonal swelling in a significant portion of patients.
- Complement C4d deposition in endothelial cells was observed in some biopsies, suggesting an immune-mediated process.
Conclusions:
- SARS-CoV-2 vaccination may be associated with diverse neuropathic symptoms in some individuals.
- These post-vaccination neuropathies may represent an immune-mediated phenomenon.
- Prompt immunotherapy, such as corticosteroids or intravenous immunoglobulin, demonstrated efficacy in improving symptoms.
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