Bilateral Facial Nerve Palsy and COVID-19 Vaccination: Causation or Coincidence?

Bell's palsy is a mononeuropathy of the facial nerve that typically causes unilateral facial paralysis. The incidence of unilateral Bell's palsy is not uncommon, but sequential or simultaneous bilateral Bell's palsy is exceedingly rare. While unilateral Bell's palsy is oftentimes idiopathic, bilateral Bell's palsy is almost exclusively explained by an identifiable trigger. In pre-clinical trials, Bell's palsy cases were recorded at higher rates in the vaccine cohort than the placebo cohort. Herein, we present a case of isolated sequential bilateral Bell's palsy that after an extensive workup, proved to be idiopathic. Notably, in the setting of a recent coronavirus disease 2019 (COVID-19) vaccine and absence of identifiable etiology, our case highlights a potential correlation of the COVID-19 vaccine and bilateral Bell's palsy.

Evaluating Patient Adherence to Routine and Symptom Indicated Colonoscopies During the COVID-19 Pandemic.

Background and aims The COVID-19 pandemic has led to significant changes in healthcare delivery. In response to these changes, patients have increasingly reduced healthcare utilization in several ways, such as medication compliance, cancer screenings, and routine wellness appointments. This study aims to quantify patient adherence rates to routine and symptom indicated colonoscopies during the COVID-19 and to assess patient medication compliance and utilization of healthcare facilities. Methods A cross-sectional study was performed at a single-center internal medicine clinic from January 2021 to April 2021. A 28-item survey was administered to patients to evaluate for adherence rates to routine and symptom indicated colonoscopies. Patients were also evaluated for rates of healthcare facility usage and medication compliance. Results Among 103 participants, 30.8% of patients who were due for routine colonoscopy either missed, refused, or rescheduled, while 16.7% of patients did so for symptom indicated colonoscopies. Nearly all respondents (94.2%) reported no change to medication compliance when compared to pre-COVID. A significant portion (36.9%) of patients reported missing a healthcare appointment at some point during the pandemic, and of the respondents who felt sick enough to visit the emergency department, 23.1% decided not to go. Conclusions During the COVID-19 pandemic, patients are deferring colorectal cancer surveillance, reducing the usage of acute care facilities, and missing routine healthcare appointments. It is important for providers to address the risks and benefits of delaying colorectal cancer screenings as well as identify physical and psychosocial barriers to patient utilization of both acute and chronic healthcare facilities. As COVID-19 restrictions inevitably continue to ease, medical providers should be aware of these potential lapses in cancer screenings and healthcare visits and be vigilant in catching patients up on their preventative health screenings.