Department of Neurology, King George's Medical University, Lucknow, UP, India.
Department of Neurology, Sanjay Gandhi Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Neurol India. 2023 Mar-Apr;71(2):209-227. doi: 10.4103/0028-3886.375420.
Indian data regarding serious neurological and psychiatric adverse events, following coronavirus disease 2019 (COVID-19) vaccination, are lacking. We, therefore, systematically evaluated cases of post-vaccinal serious neurological and psychiatric adverse reactions published from India. A systematic review of cases published from India, which were archived in PubMed, Scopus, and Google Scholar databases, was performed; pre-print databases along with ahead-of-print contents were searched in addition. Retrieved articles, as on June 27, 2022, were evaluated following PRISMA guidelines. EndNote 20 web tool was used to make a PRISMA flow chart. Individual patients' data were compiled in a tabular form. The protocol of the systematic review was registered with PROSPERO (CRD42022324183). A total of 64 records describing 136 instances of serious neurological and psychiatric adverse events were identified. More than 50% (36/64) reports were from the following four states, namely, Kerala, Uttar Pradesh, New Delhi, and West Bengal. The mean age of persons developing these complications was 44.89 ± 15.77 years. In the majority, adverse events occurred within 2 weeks of administration of the first dose of COVISHIELD vaccine. Immune-mediated central nervous system (CNS) disorders were identified in 54 instances. Guillain-Barre syndrome and other immune-mediated peripheral neuropathies were reported in 21 cases. Post-vaccinal herpes zoster was recorded in 31 vaccine recipients. Psychiatric adverse events were recorded in six patients. In Indian recipients of COVID-19 vaccine, a variety of serious neurological complications were reported. The overall risk appears minuscule. Immune-mediated central and peripheral neuronal demyelinations were the most frequently reported post-vaccinal adverse events. A large number of cases of herpes zoster have also been reported. Immune-mediated disorders responded well to immunotherapy.
印度缺乏关于 COVID-19 疫苗接种后严重神经和精神不良事件的数据。因此，我们系统地评估了在印度发表的疫苗接种后严重神经和精神不良反应病例。对在 PubMed、Scopus 和 Google Scholar 数据库中存档的来自印度的病例进行了系统评价；此外还搜索了预印本数据库和提前出版的内容。根据 PRISMA 指南评估了截至 2022 年 6 月 27 日检索到的文章。使用 EndNote 20 网络工具制作 PRISMA 流程图。将个体患者的数据以表格形式汇编。该系统评价的方案已在 PROSPERO（CRD42022324183）上注册。共确定了 64 份记录，描述了 136 例严重神经和精神不良事件。超过 50%（36/64）的报告来自以下四个邦，即喀拉拉邦、北方邦、新德里和西孟加拉邦。出现这些并发症的人的平均年龄为 44.89 ± 15.77 岁。在大多数情况下，不良事件发生在接种第一剂 COVISHIELD 疫苗后 2 周内。鉴定出 54 例免疫介导的中枢神经系统（CNS）疾病。报告了 21 例吉兰-巴雷综合征和其他免疫介导的周围神经病。31 名疫苗接种者记录了疫苗接种后带状疱疹。6 名患者记录了精神科不良事件。在印度 COVID-19 疫苗接种者中，报告了多种严重神经并发症。总体风险似乎很小。免疫介导的中枢和周围神经元脱髓鞘是最常报告的疫苗接种后不良事件。还报告了大量带状疱疹病例。免疫介导的疾病对免疫疗法反应良好。
