Acute‐onset polyradiculoneuropathy after SARS‐CoV2 vaccine in the West and North Midlands, United Kingdom


Introduction/Aims: We aimed to determine whether specific severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccines may be associated with acute-onset polyradiculoneuropathy and if they may result in particular clinical presentations. Methods: We retrospectively reviewed records of all persons presenting with acute-onset polyradiculoneuropathy from January 1, 2021, to June 30, 2021, admitted to two Neuroscience centers, of the West and North Midlands, United Kingdom. We compared subjects with previous SARS-CoV2 vaccine exposure with a local cohort of persons with acute-onset polyradiculoneuropathy admitted between 2005 and 2019 and compared admission numbers for the studied time frame with that of the previous 3 years. Results: Of 24 persons with acute-onset polyradiculoneuropathy, 16 (66.7%) presented within 4 weeks after first SARS-CoV2 vaccine. Fourteen had received the AstraZeneca vaccine and one each, the Pfizer and Moderna vaccines. The final diagnosis was Guillain-Barré syndrome (GBS) in 12 and acute-onset chronic inflammatory demyelinating polyneuropathy in 4. Among AstraZeneca vaccine recipients, facial weakness in nine persons (64.3%), bulbar weakness in seven (50%), and the bifacial weakness and distal paresthesias GBS variant in three (21.4%), were more common than in historical controls (P =.01; P =.004, and P =.002, respectively). A 2.6-fold (95% confidence interval: 1.98–3.51) increase in admissions for acute-onset polyradiculoneuropathy was noted during the studied time frame, compared to the same period in the previous 3 years. Discussion: Despite a low risk, smaller than that of SARS-CoV2 infection and its complications, exposure to the first dose of AstraZeneca SARS-CoV2 vaccine may be a risk factor for acute-onset polyradiculoneuropathy, characterized by more common cranial nerve involvement.

Publication DOI:
Divisions: College of Health & Life Sciences
Additional Information: This is the peer reviewed version of the following article: Loo, L.K., Salim, O., Liang, D., Goel, A., Sumangala, S., Gowda, A.S., Davies, B. and Rajabally, Y.A. (2021), Acute-onset polyradiculoneuropathy after SARS-CoV2 vaccine in the West and North Midlands, United Kingdom. Muscle & Nerve. Accepted Author Manuscript., which has been published in final form at  This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Uncontrolled Keywords: Guillain-Barré syndrome,chronic inflammatory demyelinating polyradiculoneuropathy,polyradiculoneuropathy,Physiology,Clinical Neurology,Cellular and Molecular Neuroscience,Physiology (medical)
Publication ISSN: 1097-4598
Full Text Link:
Related URLs: https://onlinel ... .1002/mus.27461 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2022-02
Published Online Date: 2021-11-16
Accepted Date: 2021-11-10
Authors: Loo, Lay Khoon
Salim, Omar
Liang, Di
Goel, Aimee
Sumangala, Salini
Gowda, Ashwin S.
Davies, Brendan
Rajabally, Yusuf A.



Version: Accepted Version

Access Restriction: Restricted to Repository staff only until 16 November 2022.

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