Department of Neurology and Experimental Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
Center for Stroke Research Berlin, Berlin, Germany.
J Neurol. 2023 Oct;270(10):4673-4677. doi: 10.1007/s00415-023-11895-9. Epub 2023 Jul 29.
Neurological symptoms associated with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) vaccination were discovered in the context of billions of administered vaccine doses. The clinical manifestations often resemble post Coronavirus Disease 2019 (post-COVID-19) syndrome (PCS) features and may be considered as post-COVID-19 vaccine syndrome (PVS). Data regarding frequency, severity and pathophysiological mechanisms are scarce.
We assessed routine clinical examinations in 50 patients reporting new-onset neurological symptoms after SARS-CoV-2 vaccination, including neurological examination, laboratory and electrophysiology tests, as well as self-report questionnaires measuring fatigue, depressive symptoms, anxiety, risk of somatic symptom disorder, and health-related quality of life. Patients were included when symptoms occurred after confirmed COVID-19 vaccination and without prior SARS-CoV-2 infection, and if no alternative diagnosis was found to explain the symptoms.
The most frequently reported symptoms were paraesthesia (56%), fatigue (46%) and cognitive impairment (36%). Neurological, routine laboratory, and electrophysiological examinations did not yield distinct pathological findings. Neuropsychological testing of a subgroup revealed deficits in attention, executive function and memory.
The spectrum of clinical manifestations post-vaccination poses a substantial overlap with PCS symptoms. As no pathological findings were obtained in routine diagnostics, uncertainty remains about the underlying pathophysiological mechanisms and requires further investigation beyond routine work-up.
在数十亿剂疫苗接种的背景下，发现了与严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）疫苗接种相关的神经症状。这些临床表现常类似于新冠肺炎（COVID-19）后综合征（PCS）的特征，可被视为 COVID-19 疫苗后综合征（PVS）。目前关于其发生频率、严重程度和病理生理机制的数据还很有限。
我们评估了 50 例在接种 SARS-CoV-2 疫苗后出现新发神经症状的患者的常规临床检查结果，包括神经系统检查、实验室和电生理学检查，以及自我报告的问卷，用于评估疲劳、抑郁症状、焦虑、躯体症状障碍风险和健康相关生活质量。纳入标准为：症状发生在确诊 COVID-19 疫苗接种后，且无 SARS-CoV-2 感染史，无其他可解释症状的替代诊断。
最常报告的症状是感觉异常（56%）、疲劳（46%）和认知障碍（36%）。神经科、常规实验室和电生理学检查未发现明显的病理发现。对亚组进行的神经心理学测试显示注意力、执行功能和记忆力方面存在缺陷。
接种疫苗后的临床表现与 PCS 症状有很大的重叠。由于在常规诊断中未发现病理发现，因此关于潜在的病理生理机制仍存在不确定性，需要在常规检查之外进行进一步研究。
