Pilotto Andrea, Catania Marcello, Mattioli Irene, Zoppi Nicola, Ceccardi Giulia, Rao Renata, Gipponi Stefano, Magoni Mauro, Gamba Massimo, Padovani Alessandro
Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Brescia Hospital, Brescia, Italy.
Laboratory of Digital Neurology and Biosensors, University of Brescia, Brescia, Italy.
Eur J Neurol. 2024 Apr;31(4):e16191. doi: 10.1111/ene.16191. Epub 2024 Jan 2.
The purpose of this study was to evaluate the possible correlation between SARS-CoV-2 vaccines and the onset of neurological syndromes. The aim was to challenge the association between SARS-CoV-2 vaccinations and the onset of acute functional neurological disorders (FNDs) compared to other neurological syndromes in hospitalized patients.
In this prospective cohort study, all adult inpatients consecutively admitted to a tertiary neurological centre were included. The prevalence and characteristics of neurological syndromes were compared between unvaccinated and vaccinated cases stratified according to the onset from vaccination. The study involved 843 subjects, namely 411 unvaccinated (UVC) and 432 vaccinated cases; these groups were comparable for demographics and clinical diagnosis distribution.
Compared to UVC, subjects hospitalized within the first 30 days from vaccine exhibited higher prevalence of FNDs (12.3% vs. 3.6%; odds ratio 4.2, 95% confidence interval 1.6-11.1) and headache (10.8% vs. 5%; odds ratio 4.1, 95% confidence interval 1.9-8.8) but no other neurological syndromes. The FND cases following vaccinations showed similar premorbid conditions and severity but a higher percentage of sensory symptoms and pain compared to UVC FND cases.
SARS-CoV-2 vaccination is associated with a significant short-term increased risk of FND and headache requiring hospitalization in an acute neurological setting.
本研究旨在评估新型冠状病毒2型(SARS-CoV-2)疫苗与神经综合征发病之间的可能关联。目的是探讨在住院患者中,SARS-CoV-2疫苗接种与急性功能性神经障碍(FND)发病之间的关联,并与其他神经综合征进行比较。
在这项前瞻性队列研究中,纳入了所有连续入住三级神经中心的成年住院患者。根据接种疫苗后的发病情况,对未接种疫苗和接种疫苗的病例进行分层,比较神经综合征的患病率和特征。该研究涉及843名受试者,即411名未接种疫苗者(UVC)和432名接种疫苗者;这些组在人口统计学和临床诊断分布方面具有可比性。
与UVC相比,在接种疫苗后的前30天内住院的受试者中,FND的患病率更高(12.3%对3.6%;优势比4.2,95%置信区间1.6-11.1),头痛的患病率也更高(10.8%对5%;优势比4.1,95%置信区间1.9-8.8),但没有其他神经综合征。与UVC的FND病例相比,接种疫苗后的FND病例在病前情况和严重程度方面相似,但感觉症状和疼痛的比例更高。
在急性神经疾病环境中,SARS-CoV-2疫苗接种与FND和需要住院治疗的头痛的短期风险显著增加相关。