Neurological syndromes following SARSCoV- 2 Vaccination: are medical unexplained symptoms the key players?

Background and aims: Rare neurological syndromes have been associated with SARS-CoV-2 vaccination. Despite the growing number of cases reported, the characteristics of neurological diagnosis following SARS-CoV-2 vaccination and the underlying etiologic mechanisms still need further investigations. The aim of this study is to evaluate the association between specific neurological symptoms and syndromes and SARS-CoV-2 vaccination. Methods: In this retrospective, single center cohort study, we included all adult inpatients consecutively admitted to the Department of Clinical and Experimental Sciences, Neurology Unit, of the ASST Spedali Civili Hospital, Brescia, from January 2021 to August 2021. Results: Out of 871 consecutive patients admitted to Neurology Department, 102 and 61 subjects reported SARS-CoV-2 vaccination within 60 and 30 days, respectively. The most common neurological diagnosis following vaccination included cerebrovascular diseases (n=32), transient medical/neurological unexplained symptoms with negative instrumental tests (MUS, n=25), epileptic disorders (n=11) and demyelinating diseases (n=10). When compared to non-vaccinated cases, MUS emerged as the only diagnosis with higher prevalence in post-vaccine cases at 60 and 30 days (24,5% and 38% vs 7,2% of whole cohort). Conclusion: Unexplained transient neurological symptoms appeared to be the most common neurological condition following SARS-CoV-2 vaccination in comparison to nonvaccinated cases.

Myalgia and fatigue as long term symptoms in COVID-19 patients: A 1-year follow-up

Background. COVID-19 is caused by SARS-CoV-2 virus and in many cases lead to a pneumonia. However a number of neumuscular manifestations have been associated to SARS-CoV-2 infection. Furthermore, multiorgan symptoms after COVID-19 are being reported by increasing numbers of patients, ranging from cough to fatigue and muscle pain. However, the long-term health consequences of COVID-19 remain largely unclear. Methods: We evaluated 124 patients hospitalized between march and May 2020 for SARS-COV-2 associated pneumonia at 6 and 12 months. We retrospectively collected clinical, laboratory and radiological information available. for each patient, cognitive tests, scales for depression and anxiety and a specific Fatigue Severity Scale (FSS) were performed. Results. Twenty-five patients died during hospitalization. At 12 months follow up 85 patient were evaluated. Eighty-seven (70%) patiens were male and mean age was 67.3 years. During hospitalization 43 (36.5%) of patients complain of myalgia. This patients had higher CK levels than patients who did not (534 U/L vs 93 U/l, p < 0.001). At 12 months 42% of patients complain about myalgia while 34% about fatigue. Mean FSS value were 32.93, and were significatively higher in patiets who complain about fatigue (41.52 vs 27.08 p < 0.001) and Muscle pain (40.84 vs 26.80, p < 0.001) compared to who did not. Conclusions. During hospitalization for COVID-19 myalgia was associated with an higher level of CK, suggesting a possible muscle involvement. At 12 month myalgia and fatigue were present in a more than a third of patient suggesting that this manifestation could be one of the main COVID-19 sequelae.