Neuromuscular diseases associated with COVID-19 vaccines: a systematic review and pooled analysis of 258 patients

BMC Neurol. 2023 Dec 11;23(1):437. doi: 10.1186/s12883-023-03486-y.

Abstract

Background: Neuromuscular diseases (NMD) emerged as one of the main side effects of the COVID-19 vaccination. We pooled and summarized the evidence on the clinical features and outcomes of NMD associated with COVID-19 vaccination.

Methods: We comprehensively searched three databases, Medline, Embase, and Scopus, using the key terms covering "Neuromuscular disease" AND "COVID-19 vaccine", and pooled the individual patient data extracted from the included studies.

Results: A total of 258 NMD cases following COVID-19 have been reported globally, of which 171 cases were Guillain-Barré syndrome (GBS), 40 Parsonage-Turner syndrome (PTS), 22 Myasthenia Gravis (MG), 19 facial nerve palsy (FNP), 5 single fiber neuropathy, and 1 Tolosa-Hunt syndrome. All (100%) SFN patients and 58% of FNP patients were female; in the remaining NMDs, patients were predominantly male, including MG (82%), GBS (63%), and PTS (62.5%). The median time from vaccine to symptom was less than 2 weeks in all groups. Symptoms mainly appeared following the first dose of vector vaccine, but there was no specific pattern for mRNA-based.

Conclusion: COVID-19 vaccines might induce some NMDs, mainly in adults. The age distribution and gender characteristics of affected patients may differ based on the NMD type. About two-thirds of the cases probably occur less than 2 weeks after vaccination.

Keywords: COVID-19 vaccine; Facial nerve palsy; Guillain-Barré syndrome; Myasthenia gravis; Neuromuscular diseases; Parsonage-turner syndrome; Peripheral neuropathy; Small fiber neuropathy; Tolosa-Hunt syndrome.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Bell Palsy*
  • COVID-19 Vaccines / adverse effects
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Facial Paralysis*
  • Female
  • Guillain-Barre Syndrome* / epidemiology
  • Guillain-Barre Syndrome* / etiology
  • Humans
  • Male
  • Myasthenia Gravis*
  • Neuromuscular Diseases* / epidemiology

Substances

  • COVID-19 Vaccines