Guillain-Barré syndrome following SARS-CoV-2 vaccination in the UK: a prospective surveillance study.

Autor:	Tamborska AA; National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK.; Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK., Singh B; National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK.; Tropical and Infectious Diseases Unit, Royal Liverpool University Hospital, Liverpool, UK., Leonhard SE; Department of Neurology, Erasmus MC, Rotterdam, the Netherlands., Hodel EM; National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK.; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK., Stowe J; UK Health Security Agency, London, UK., Watson-Fargie T; Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK., Fernandes PM; Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK., Themistocleous AC; Nuffield Department of Clinical Neurociences, University of Oxford, Oxford, UK., Roelofs J; Neurosciences Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK., Brennan K; Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK., Morrice C; GAIN (Guillain-Barré & Associated Inflammatory Neuropathies) Charity, Sleaford, UK., Michael BD; National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK.; Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK., Jacobs BC; Department of Neurology and Immunology, Erasmus MC, Rotterdam, The Netherlands., McDonald H; NIHR Health Protection Research Unit in Vaccines and Immunisation, London School of Hygiene & Tropical Medicine, London, UK., Solomon T; National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK.; Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.
Jazyk:	angličtina
Zdroj:	BMJ neurology open [BMJ Neurol Open] 2022 Jul 12; Vol. 4 (2), pp. e000309. Date of Electronic Publication: 2022 Jul 12 (Print Publication: 2022).
DOI:	10.1136/bmjno-2022-000309
Abstrakt:	Objective: To investigate features of Guillain-Barré syndrome (GBS) following SARS-CoV-2 vaccines and evaluate for a causal link between the two. Methods: We captured cases of GBS after SARS-CoV-2 vaccination through a national, open-access, online surveillance system. For each case, the certainty of GBS was graded using the Brighton criteria, and the relationship to the vaccine was examined using modified WHO Causality Assessment criteria. We compared age distribution of cases with that of prepandemic GBS cases and clinical features with the International GBS Outcome Study (IGOS). Results: Between 1 January and 30 June 2021, we received 67 reports of GBS following the ChAdOx1 vaccine (65 first doses) and three reports following the BNT162b2 vaccine (all first doses). The causal association with the vaccine was classified as probable for 56 (80%, all ChAdOx1), possible for 12 (17%, 10 ChAdOx1) and unlikely for two (3%, 1 ChAdOx1). A greater proportion of cases occurred in the 50-59 age group in comparison with prepandemic GBS. Most common clinical variants were sensorimotor GBS (n=55; 79%) and facial diplegia with paraesthesias (n=10; 14%). 10% (n=7/69) of patients reported an antecedent infection, compared with 77% (n=502/652) of the IGOS cohort (p<0.00001). Facial weakness (63% (n=44/70) vs 36% (n=220/620); p<0.00001) and sensory dysfunction (93% (n=63/68) vs 69% (n=408/588); p=0.00005) were more common but disease severity and outcomes were similar to the IGOS study. Interpretation: Most reports of GBS followed the first dose of ChAdOx1 vaccine. While our study cannot confirm or refute causation, this observation, together with the absence of alternative aetiologies, different than expected age distribution and the presence of unusual clinical features support a causal link. Clinicians and surveillance bodies should remain vigilant to the possibility of this very rare adverse event and its atypical variants. Competing Interests: Competing interests: TS was chair/cochair of the UK Research and Innovation/National Institute for Health Research COVID-19 Rapid Response and Rolling Funding Initiatives, was an Advisor to the UK COVID-19 Therapeutics Advisory Panel and is a member of the UK Medicines and Healthcare Products Regulatory Agency COVID-19 Vaccines Benefit Risk Expert Working Group. BCJ is a chair of Steering Committee of IGOS. HM is an invited expert for the Commission on Human Medicines COVID-19 Vaccines Safety Surveillance Methodologies Expert Working Group. The remaining authors have no relevant conflict of interest to declare. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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