Peripheral nervous system involvement in SARS-CoV-2 infection: a review of the current pediatric literature.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the pathogen responsible for the pandemic health emergency declared by the World Health Organization in March 2020. During the first part of the pandemic, adults showed mild to severe respiratory symptoms. Children seemed initially exempt, both from acute and subsequent complications. Hyposmia or anosmia were promptly identified as the main symptoms of acute infection, so neurotropism of SARS-CoV-2 was immediately suspected. (1, 2). As the emergency progressed, post infectious neurological complications were described also in pediatric population (3). Cases of cranial neuropathy in connection with acute SARS-CoV-2 infection have been reported in pediatric patients, as an isolate post infectious complication or in the context of the multisystem inflammatory syndrome in children (MIS-C) (4-6). Neuroinflammation is thought to be caused by several mechanisms, among which immune/autoimmune reactions (7), but so far, no specific autoantibody has been identified. SARS-CoV-2 can enter the central nervous system (CNS) directly and/or infect it retrogradely, through the peripheral nervous system (PNS), after replicating peripherally; several factors regulate invasion and subsequent neuroinflammation. Indeed, direct/secondary entry and replication can activate CNS-resident immune cells that, together with peripheral leukocytes, induce an immune response and promote neuroinflammation. In addition, as we will discuss in the following review, many cases of peripheral neuropathy (cranial and non-cranial) have been reported during or after SARS-CoV-2 infection. However, some authors have pointed out that the increase of cranial roots and ganglia in neurological imaging is not always observed in children with cranial neuropathy. (8). Even if a variety of case reports were published, opinions about an increased incidence of such neurologic diseases, linked to SARS-CoV-2 infection, are still controversial (9-11). Facial nerve palsy, ocular movements abnormalities and vestibular alterations are among the most reported issues in pediatric population (3-5). Moreover, an increased screen exposure imposed by social distancing led to acute oculomotion's disturbance in children, not primarily caused by neuritis (12, 13). The aim of this review is to suggest food for thought on the role of SARS-CoV-2 in neurological conditions, affecting the peripheral nervous system to optimize the management and care of pediatric patients.

Infection routes, invasion mechanisms, and drug inhibition pathways of human coronaviruses on the nervous system.

So far, numerous studies have reported on how coronaviruses affect the human nervous system. However, these studies mainly focused on the impact of a single coronavirus on the nervous system, and failed to fully report the invasion mechanisms and the rules of symptoms of the seven human coronaviruses. This research can assist medical professionals in identifying the regularity of coronavirus invasion into the nervous system by examining the impacts of human coronaviruses on the nervous system. Meanwhile, the discovery also helps humans to prevent the damage to the human nervous system caused by the more novel coronavirus in advance, thus reducing the rate of disease transmission and fatality caused by such viruses. In addition to describing the structures, routes of infection, and symptomatic manifestations of human coronaviruses, this review also finds that the structures of human coronaviruses correlate with virulence, pathways of infection, and blocking mechanisms of drugs. This review can provide a theoretical basis for the research and development of related drugs, promote the prevention and treatment of coronavirus infectious diseases, and contribute to global epidemic prevention.

Neurological complications associated with COVID-19. Saint Vincent de Paul Hospital, 2021

Background: COVID-19 is caused by the SARS-Cov-2 virus and presents a wide range of symptoms, both in its acute phase and in its chronic phase. Among the systems that it affects is the Nervous, due to its neurotropic mechanism. Objective: to determine the risk of neurological complications associated with the COVID-19 severity in adult patients. Methods: a descriptive and cross-sectional study was carried out, which included 143 positive patients for COVID-19 treated at the San Vicente de Pa & uacute;l Hospital, in Ibarra, Ecuador, during 2021. Neurological complications and the severity of the COVID-19 disease were analyzed. As a measure of association for these variables, the Fisher Test was used (p = <= 0.05) and a bivariate analysis was performed. Results: 54% of the patients presented neurological complications of the Central Nervous System, while 46% were of the Peripheral Nervous System;and mild-moderate severity was the most frequent (41%), and hearing impairment had the highest statistical probability of occurring (OR= 74.968;CI: 95%). The case fatality rate in these patients was 7.1%;and in those with neurological complications, 8.4%.Conclusion: the neurological sequelae most likely to occur were hearing impairment and taste impairment, in patients with mild severity and serious severity, respectively;in addition to polyneuropathy in patients with critical severity, which also occurred in deceased patients. Keywords: Coronavirus infections;neurologic manifestations;central nervous system;peripheral nervous system;severity of illness index

Neurological Symptoms Common in Covid-19 Patients: A Retrospective Observational Study

In December 2019, a novel coronavirus outbreak spread rapidly all over the world. The virus is known to be neuroinvasive, but much is still unknown. In this study, we aimed to pres-ent the main neurologic symptoms in patients who were diagnosed with coronavirus disease 2019 (COVID-19). The study was conducted retrospectively by phoning 156 patients in Turkey diagnosed with COVID-19 through real-time polymerase chain reaction;only 100 patients could be reached. Data about their demographics, initial symptoms, neurological symptoms, and sleeping habits were collected. During the disease process, 66% had at least one neurological symptom, 55% had central nervous system symptoms, 42% had peripheral nervous system symptoms, and 64% had sleep disturbances and myalgia. Impaired consciousness, smell and taste impairments, and sleep disturbances were significantly higher in patients with positive chest computed tomography imaging (p < 0.05). Neurological symptoms were observed in COVID-19, as in other coronaviruses. Headache in particular was the most common symptom in our population. In patients with respiratory system findings, the detec-tion of certain neurological symptoms such as smell-taste impairments, impaired consciousness, and sleep disorders were more common. We concluded that COVID-19 patients should be approached in a more holistic way, taking the nervous system into account.Copyright © 2022, Dr. Mladen Stojanovic University Hospital. All rights reserved.

Clinical-epidemiological behavior of post-COVID-19 syndrome in patients at Andres Ortiz Polyclinic, 2021

Introduction: post-COVID-19 syndrome is the set of signs and symptoms that develop during or after an infection compatible with COVID-19, that persist for more than 12 weeks and are not explained by an alternative diagnosis. Background: to characterize the clinical-epidemiological behavior of the post-COVID-19 syndrome in patients at the Andres Ortiz Polyclinic. Method: a descriptive and cross-sectional observational study was carried out from October to December 2021, in a population of 51 subjects that was studied in its entirety. The analysis was descriptive. Results: patients with 50-59 years (n = 20;39.2%), female (n = 32;62.7%) predominated. The most frequently affected organ system was the respiratory (n = 19;37.2%), while the symptoms were: chronic fatigue (n = 15;29.4%), shortness of breath (n = 11;21.5%) and cough (n = 8, 15.6%). Among the patients with respiratory (n = 30), cardiovascular (n = 24) and neurological (n = 10) diseases, the most frequent were, respectively: pulmonary fibrosis (n = 17;56.7%), cardiac arrhythmias (n = 11;45.8%) and peripheral neuropathies (n = 5;50%). Conclusions: post-COVID-19 syndrome occurred mainly between the ages of 50 and 59, in female patients, with symptoms of chronic fatigue, shortness of breath and cough, as well as pulmonary fibrosis, cardiac arrhythmias and peripheral neuropathies as main comorbidities.

Neurologic Manifestations of COVID-19.

Coronavirus disease (COVID-19) caused by a new coronavirus, SARS-CoV-2, has become a serious health problem throughout the world. Although COVID-19 primarily presents as an acute respiratory tract infection, many neurological findings have also been described in patients. Neurological findings are classified into three groups as central, peripheral nervous system and musculoskeletal system. The most common central nervous system symptom is headache. Encephalitis, encephalopathy, seizures, acute ischemic stroke are also seen. The most common symptoms in the peripheral nervous system are loss of smell and taste. Myalgia, myositis and rhabdomyolysis also can be seen in musculoskeletal system involvement. Awareness of the neurological symptoms by physicians will be beneficial in early diagnosis and treatment of the disease.Copyright © 2022 Ankara Pediatric Hematology Oncology Training and Research Hospital. All rights reserved.

Difficulties of differential diagnosis of polyneuropathy developed after Gam-COVID-Vac vaccination on the background of combined infectious pathology (clinical case).

The clinical case describes the difficulties of differential diagnosis of polyneuropathy that developed, after Gam-Covid-Vac vaccination on the background, of combined, infectious pathology (HIV infection, tick-borne borreliosis, COVID-19) in a young woman. It is shown that various infectious and noninfectious diseases with similar clinical symptoms (peripheral nervous system, affliction.) occurring simultaneously in one patient can significantly affect each other's course and. complicate the establishment of the true cause of polyneuropathy. It should, be noted, that in this example, the establishment of a final diagnosis was carried out collectively, by consensus, and. was based, on the effectiveness of etiotropic (antibacterial) treatment, which in fact was an exjuvantibus therapy option, which made it possible to establish the most probable etiology of polyneuropathy -tick-borne borreliosis. In turn, HIV infection and. possibly vaccination, according to the authors, could, cause immunosuppression, which, affected, the degree of dissemination, of Borrelia burgdorferi. It is also likely that the insufficient immune response in combination. with the cascade plasma filtration session affected the initial dubious results of the serological tests, which further complicated. the diagnosis.Copyright © 2022 Authors. All rights reserved.

Difficulties of differential diagnosis of polyneuropathy developed after Gam-COVID-Vac vaccination on the background of combined infectious pathology (clinical case).

The clinical case describes the difficulties of differential diagnosis of polyneuropathy that developed, after Gam-Covid-Vac vaccination on the background, of combined, infectious pathology (HIV infection, tick-borne borreliosis, COVID-19) in a young woman. It is shown that various infectious and noninfectious diseases with similar clinical symptoms (peripheral nervous system, affliction.) occurring simultaneously in one patient can significantly affect each other's course and. complicate the establishment of the true cause of polyneuropathy. It should, be noted, that in this example, the establishment of a final diagnosis was carried out collectively, by consensus, and. was based, on the effectiveness of etiotropic (antibacterial) treatment, which in fact was an exjuvantibus therapy option, which made it possible to establish the most probable etiology of polyneuropathy -tick-borne borreliosis. In turn, HIV infection and. possibly vaccination, according to the authors, could, cause immunosuppression, which, affected, the degree of dissemination, of Borrelia burgdorferi. It is also likely that the insufficient immune response in combination. with the cascade plasma filtration session affected the initial dubious results of the serological tests, which further complicated. the diagnosis.Copyright © 2022 Authors. All rights reserved.

Neurological manifestations associated with SARS-CoV-2 infection: an updated review

SARS-CoV-2 is a single-stranded RNA virus that belongs to the group of seven coronaviruses that affect humans, and its infection causes the COVID-19 disease. The association between the COVID-19 condition and risk factors of neurological manifestations is unclear to date. This review aims to update the main neurological manifestations associated with SARS-CoV-2 disease. First, we present the hypothesis of the neuroinvasion mechanisms of SARS-CoV-2. Then, we discuss the possible symptoms related to patients with COVID-19 infection in the central and peripheral nervous systems, followed by the perspectives of diagnosis and treatment of possible neurological manifesta-tions. The hypothesis of the neuroinvasion mechanism includes direct routes, as the virus crosses the blood-brain barrier or the ACE2 receptor pathway role, and indirect pathways, such as malfunctions of the immune system and vascular system dysregulation. Various studies report COVID-19 consequences, such as neuroanatomic alterations and cognitive impairment, besides peripheral condi-tions, such as anosmia, ageusia, and Guillain Barre Syndrome. However, the het-erogeneity of the studies about neurologic damage in patients after COVID-19 infection precludes any generalization of current findings. Finally, new studies are necessary to understand the adequate diagnosis, therapeutic method of early treatment, and risk group of patients for neurological manifestations of COVID-19 post-infection.Copyright © 2023, Instituto de Investigaciones Clinicas. All rights reserved.

Two Case Reports of Chronic Inflammatory Demyelinating Polyneuropathy After COVID-19 Vaccination.

The occurrence of chronic inflammatory demyelinating polyneuropathy (CIDP) related to coronavirus disease 2019 (COVID-19) has rarely been reported. We describe two patients who were diagnosed with CIDP after COVID-19 vaccination. A 72-year-old man presented with a progressive tingling sensation and weakness below both knees for two weeks. He had been vaccinated against COVID-19 (mRNA-1273 vaccine) a month before the appearance of symptoms. Demyelinating polyneuropathy was observed in the nerve conduction studies (NCS). Intravenous immunoglobulin (IVIg) was administered under the diagnosis of Guillain-Barré syndrome (GBS), and his symptoms were improved. However, his symptoms relapsed at 10 weeks from the onset. Oral prednisolone, azathioprine, and IVIg were administered as treatment. The second case was a 50-year-old man who complained of a bilateral leg tingling sensation and gait disturbance lasting four weeks. He had received the Ad26.COV2.S vaccine against COVID-19 five weeks prior. Demyelinating polyneuropathy was observed in the NCS. He was treated with oral prednisolone, azathioprine, and IVIg for CIDP because his symptoms had lasted for more than 12 weeks from the onset. A causal relationship has not been established between COVID-19 vaccination and CIDP; however, CIDP may follow COVID-19 vaccination. As CIDP treatment is different from that for GBS, clinicians should closely monitor patients diagnosed with GBS associated with COVID-19 whether they deteriorate after initial treatment.

Neurologic Manifestations of COVID-19

Coronavirus disease (COVID-19) caused by a new coronavirus, SARS-CoV-2, has become a serious health problem throughout the world. Although COVID-19 primarily presents as an acute respiratory tract infection, many neurological findings have also been described in patients. Neurological findings are classified into three groups as central, peripheral nervous system and musculoskeletal system. The most common central nervous system symptom is headache. Encephalitis, encephalopathy, seizures, acute ischemic stroke are also seen. The most common symptoms in the peripheral nervous system are loss of smell and taste. Myalgia, myositis and rhabdomyolysis also can be seen in musculoskeletal system involvement. Awareness of the neurological symptoms by physicians will be beneficial in early diagnosis and treatment of the disease.

News and Current Events. COVID-19 Infection Related to Three-Times-Higher Risk of Neuropathy

The article reports on the findings of a study conducted by researchers at Washington University School of Medicine revealing that people who tested positive for COVID-19 are more at risk of neuropathy.

Guillain-Barre syndrome in SARS CoV-2: Case series of uncommon neurological complication from tertiary care center, Bengaluru, South India

Coronavirus disease is an infectious disease caused by severe acute respiratory syndrome-coronavirus 2 virus. It predominantly affects respiratory system causing fever, cough, and breathlessness. But it can also affect central nervous system and peripheral nervous system. It is important that physicians keep a high index of suspicion for patients with neurologic symptoms following a recent or during COVID-19 infection. The low rate of initial diagnosis is alarming, as few of the percentage of patients with Guillain-Barre syndrome will develop respiratory muscle weakness requiring invasive ventilation. The ability to recognize the disease process could lead to life saving management. Furthermore, the initiation of therapy such as plasma exchange or intravenous immunoglobulin leads to an accelerated recovery time. [ FROM AUTHOR]

Neurologic Manifestations of COVID-19.

Coronavirus disease (COVID-19) caused by a new coronavirus, SARS-CoV-2, has become a serious health problem throughout the world. Although COVID-19 primarily presents as an acute respiratory tract infection, many neurological findings have also been described in patients. Neurological findings are classified into three groups as central, peripheral nervous system and musculoskeletal system. The most common central nervous system symptom is headache. Encephalitis, encephalopathy, seizures, acute ischemic stroke are also seen. The most common symptoms in the peripheral nervous system are loss of smell and taste. Myalgia, myositis and rhabdomyolysis also can be seen in musculoskeletal system involvement. Awareness of the neurological symptoms by physicians will be beneficial in early diagnosis and treatment of the disease. Copyright © 2022 Ankara Pediatric Hematology Oncology Training and Research Hospital. All rights reserved.

Guillain-Barré syndrome associated with COVID-19: A systematic review.

With the outbreak of coronavirus disease 2019 (COVID-19), the whole world was impacted by a pandemic. With the passage of time and knowledge about the dynamics and viral propagation of this disease, the short-, medium- and long-term repercussions are still being discovered. During this period, it has been learned that various manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect the nervous system. In recent months, a variety of studies and case reports have proposed an association between COVID-19 and Guillain-Barré syndrome (GBS). The present work aims to systematically review the publications available to date to verify the relationship between these two pathologies and the characteristics of post-COVID GBS. There were 156 studies included in this work, resulting in a total of 436 patients. The findings show a mean age of the patients of 61,38 years and a male majority. The GBS symptoms began on average 19 days after the onset of COVID-19 infection. Regarding GBS, the main manifestations found included generalized weakness, reflex reduction, facial paresis/paralysis and hypoesthesia. As expected, the most common result in cerebrospinal fluid (CSF) analysis was albuminocytological dissociation. A pattern of blood analysis findings common to all patients was not observed due to non-standardization of case reports. Regarding electrodiagnostic studies, acute inflammatory demyelinating polyneuropathy (AIDP) appeared as the most common subtype of GBS in this study. There have been reports, to a lesser extent, of acute motor axonal neuropathy (AMAN), acute sensorimotor axonal neuropathy (AMSAN), the pharyngeal-cervical-brachial variant (PCB), and Miller-Fisher syndrome (MFS). The GBS treatment used was mainly intravenous immunoglobulin (IVIG) and plasma exchange (PLEX). Therefore, the present study reports a high prevalence of hospitalization and intensive care units ICU admissions, conjecturing a relationship between the development of GBS and the severity of COVID-19. Despite the severity, most patients showed improvement in GBS symptoms after treatment, and their residual symptoms did not include motor involvement. Therefore, the development of GBS seems to be related to COVID-19 infection, as reported by the present systematic review.

Safety and Efficacy of Sars-Cov-2 Vaccination in 1237 Patients with Primary Sjogren Syndrome

Objectives. To investigate the safety and efficacy of SARS-Cov-2 vaccination in a large international cohort of patients with primary Sjogren syndrome due to scarcity of data in this population. Methods. By the first week of May 2021, all Big Data Sjogren Consortium centers had been contacted and asked for Registry patients to be included in the study if they had received at least one dose of any SARS-CoV-2 vaccine. The in-charge physician asked patients about local and systemic reactogenicity, using a pre-defined electronic questionnaire to collect epidemiologic data, COVID 19 vaccination data, and COVID 19 vaccination side effects. Adverse events were defined as those reported by the patient at the site of injection within 7 days from vaccination (reactogenicity) as local adverse events, systemic symptoms as systemic side effects, and postvaccination AEs of special interest related to SS as SS flares. Results. The vaccination data of 1237 patients (1170 women, with a mean age at diagnosis of primary SjS of 50.5 13.2) were received. A total of 835 patients (67 percent) reported any adverse event, including local (53 percent) and systemic (50 percent) AEs. Subjective symptoms (63%) were the most common local AEs, followed by objective signs at the injection site (16%) and general symptoms were the most commonly reported systemic AEs (46 percent), followed by musculoskeletal (25 percent), gastrointestinal (9 percent), cardiopulmonary (3 percent), and neurological (2 percent). People under 60 years old had a higher risk of developing AE after vaccination (OR 2.48, CI 95 1.89-3.27 percent), as did those with low systemic SS activity (OR 1.62, CI 95 1.22-2.15) and those who received mRNA vaccines, according to a multivariate analysis (OR 1.57, CI 95 percent 1.12- 2.18). The risk of developing systemic AEs was also higher in women (OR 2.85, CI 95 percent 1.60-5.2346), White people (OR 1.73, CI 95 1.14-2.65), and those who received a deficient vaccination regimen (OR 1.78, CI 95 1.12-2.88 percent). In addition to 141 (11%) patients who reported a significant worsening/exacerbation of their pre-vaccination sicca symptoms as a result of post-vaccination SS flares, 15 (1.2%) patients (13 women, mean age at vaccination 41.9 years) reported active involvement in the glandular (n=8), articular (n=7), cutaneous (n=6), pulmonary (n=2), and peripheral nervous system (n=1) domains as post-vaccination systemic flare. All side effects and flares subsided within 1-3 weeks, with no lasting effects or deaths. In terms of vaccination efficacy, breakthrough SARS-CoV-2 infection was confirmed after vaccination in three (0.24 percent) patients, all of whom recovered completely, and positive anti-SARS-Cov-2 antibodies were detected in approximately 95 percent of vaccinated SjS patients, according to data available. Conclusions. SARS-CoV-2 vaccination in patients with primary SjS, like other vaccines with adequate response and no safety signals, raised no concerns about the vaccine's efficacy or safety.

[Guillain-Barre syndrome associated with COVID-19]. / Sindrom Giiena­Barre, assotsiirovannyi s COVID-19.

This paper reports two cases of Guillain-Barre syndrome associated with coronavirus infection COVID-19. The clinical symptoms and neurological status of patients, the data of the additional examination and the features of the prescribed therapy are described in detail. The issue of the tropicity of the SARS-CoV-2 virus to human nervous tissue and its possible ways of affecting the peripheral nervous system is discussed.

[COVID-19-associated damage of the peripheral nervous system]. / COVID-19-assotsiirovannye porazheniya perifericheskoi nervnoi sistemy.

Based on the available literature data, the article discusses the prevalence of various forms of damage of the peripheral nervous system in COVID-19 and in the post-COVID period. Information about the clinical features and the course of individual cranial neuropathies, chronic dysimmune neuropathies, Guillain-Barré syndrome, drug-induced neuropathies, fine fiber neuropathy, myasthenia gravis and polyneuropathy of critical conditions was systemized in the context of coronavirus infection. SARS-CoV-2 can trigger various stages of pathogenesis, including neuroimmune ones, which cause long-term consequences of COVID-19, including those associated with the damage of the peripheral nervous system. Awareness of COVID-19-associated pathological conditions will allow assessment of the possible risks of damage of the peripheral nervous system, recognize them at early stages and develop more effective approaches for treatment.

A Systematic Review of Neurological Manifestations of COVID-19.

The coronavirus can infect the upper respiratory tract, sinuses, and nose, and its severity manifests in its respiratory symptoms and neurological and psychological consequences. The majority of people who have COVID-19 present with moderate flu-like illness, and patients who are elderly with comorbid conditions, such as hypertension and diabetes, are more prone to experience severe illness and death. However, in the ongoing COVID-19 pandemic, neurological consequences have become a substantial source of morbidity and mortality. COVID-19 poses a global hazard to the nervous system because of its widespread dispersion and multiple pathogenic pathways. This review offers a critical assessment of the acute and long-term neurological effects of the COVID-19 virus. Some neurological problems include headache, dizziness, myalgia/fatigue, meningitis, ischemic/hemorrhagic stroke, and myelitis. Other people who have contracted COVID-19 also exhibit neurological features such as loss of taste and smell, reduced consciousness, and Guillain-Barré syndrome. This study seeks to help neurologists comprehend the wide range of neurologic aspects of COVID-19, as understanding neurological symptoms may help with the management and enhance the patient's outcomes.

Symptoms Potentially Related to Small Fiber Neuropathy (SFN) and Anticovid Vaccines: An International Journal of Medical Toxicology and Drug Experience

Introduction: SFN is a relatively rare condition related to finer fibers of peripheral nervous system. A specific diagnostic procedure is necessary to reach a correct diagnosis.The most frequently reported symptoms are: pain (described as burning or a sensation of intense heat, as "aching cold", "pinpricks", "electric shocks),paraesthesia (spontaneous sensations of tingling,numbness,itching),dysesthesia and allodynia. Some published papers hypothesized a correlation between SFN and anticovid vaccine. Objective: Study target was to analyze the adverse events following immunization (AEFI) reported in our ASL (resident population 1,221,857, ¼ regional population) potentially linked to the SFN symptoms. Methods: Data relating to AEFI were extrapolated from the National Pharmacovigilance Network (NPN), while data referring to administered doses were extracted from the ASL QlinkView platform. Results: From 27 December 2020 to 26 April 2022, 624 reports, relating to vaccines anticovid AEFI, were received and recorded in the NPN. 2.109 AEFI were described in these reports. Administered vaccines: Comirnaty (346/624 sheets;1.164/2.109AEFI;2.092.042/ 3.028.781 total administered doses), the most reported AEFI were related to general pathologies: pain, wheal or erythema at the injection site, headache, fever, asthenia, nausea, malaise, tachycardia, muscle pain, fatigue, joint pain (25% of 1.164 AEFI). Other described symptoms: other pains, burning, itching, paraesthesia, tingling, numbness, allodynia, potentially linked to SFN (17.3% of 1.164 AEFI);Spikevax (112/624 sheets;392/2.109 AEFI;607.626/ 3.028.781 doses),the most reported AEFI, like Comirnaty, were related to the injection site (26% of 392 AEFI), while the potentially symptoms related to SFN were the 20.2% of 392 AEFI;Vaxzevria (146/624 sheets;512/2.109 AEFI;298.188/3.028.781 doses), the most reported AEFI, related to general pathologies, were the 33% of 512 AEFI, while potentially symptoms related to SFN were the 18.8%. Finally, as regards the Janssen vaccine (10/624 sheets;32/2.109 AEFI;30.702/3.028.781 doses), the most described events, related to general pathologies, are the 47% of the 32 AEFI, while 31% are potentially linked to the of SFN symptoms. No AEFI was reported related to the 223 doses about Novavax vaccine. The causality assessment was defined correlatable about 37 records (6% of 624 records). 12/37 records describe potentially linked to SFN symptoms (6 Vaxzevria (1%), 3 Comirnaty (0.5%) and 3 Spikevax (0.5%)). Conclusion: The analysis about AEFI reported in our ASL related to anticovid vaccines underlined the existence of symptoms potentially linked to SFN, although only in a few cases it was evaluated a causality assessment to vaccination. Just a specific diagnostic procedure can confirm the diagnosis and the correlation. Therefore, the correlation between SFN and vaccine needs larger-scale studies and insights for a correct evaluation.