Association of Sars-Cov-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-Analysis

Association of Sars-Cov-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-Analysis Publisher Pubmed

Rafati A¹ ; Pasebani Y¹ ; Jameie M^{2, 3} ; Yang Y⁴ ; Jameie M^{2, 3} ; Ilkhani S⁶ ; Amanollahi M² ; Sakhaei D⁷ ; Rahimlou M⁸ ; Kheradmand A^{9, 10, 11, 12}

Show Affiliations

1. School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2. Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
3. Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran
4. Department of Neurology and Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, United States
5. Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
6. Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
7. School of Medicine, Sari Branch, Islamic Azad University, Sari, Iran
8. Department of Nutrition, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
9. Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD, United States
10. Department of Neuroscience, Johns Hopkins University, School of Medicine, Baltimore, MD, United States
11. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, United States
12. Laboratory for Computational Sensing and Robotics, Johns Hopkins University, School of Medicine, Baltimore, MD, United States

Source: JAMA Otolaryngology - Head and Neck Surgery Published:2023

Abstract

Importance: Bell palsy (BP) has been reported as an adverse event following the SARS-CoV-2 vaccination, but neither a causative relationship nor a higher prevalence than in the general population has been established. Objective: To compare the incidence of BP in SARS-CoV-2 vaccine recipients vs unvaccinated individuals or placebo recipients. Data Sources: A systematic search of MEDLINE (via PubMed), Web of Science, Scopus, Cochrane Library, and Google Scholar from the inception of the COVID-19 report (December 2019) to August 15, 2022. Study Selection: Articles reporting BP incidence with SARS-CoV-2 vaccination were included. Data Extraction and Synthesis: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and was conducted with the random- and fixed-effect models using the Mantel-Haenszel method. The quality of the studies was evaluated by the Newcastle-Ottawa Scale. Main Outcomes and Measures: The outcomes of interest were to compare BP incidence among (1) SARS-CoV-2 vaccine recipients, (2) nonrecipients in the placebo or unvaccinated cohorts, (3) different types of SARS-CoV-2 vaccines, and (4) SARS-CoV-2-infected vs SARS-CoV-2-vaccinated individuals. Results: Fifty studies were included, of which 17 entered the quantitative synthesis. Pooling 4 phase 3 randomized clinical trials showed significantly higher BP in recipients of SARS-CoV-2 vaccines (77525 vaccine recipients vs 66682 placebo recipients; odds ratio [OR], 3.00; 95% CI, 1.10-8.18; I2= 0%). There was, however, no significant increase in BP after administration of the messenger RNA SARS-CoV-2 vaccine in pooling 8 observational studies (13518026 doses vs 13510701 unvaccinated; OR, 0.70; 95% CI, 0.42-1.16; I2= 94%). No significant difference was found in BP among 22978880 first-dose recipients of the Pfizer/BioNTech vaccine compared with 22978880 first-dose recipients of the Oxford/AstraZeneca vaccine (OR, 0.97; 95% CI, 0.82-1.15; I2= 0%). Bell palsy was significantly more common after SARS-CoV-2 infection (n = 2822072) than after SARS-CoV-2 vaccinations (n = 37912410) (relative risk, 3.23; 95% CI, 1.57-6.62; I2= 95%). Conclusions and Relevance: This systematic review and meta-analysis suggests a higher incidence of BP among SARS-CoV-2-vaccinated vs placebo groups. The occurrence of BP did not differ significantly between recipients of the Pfizer/BioNTech vs Oxford/AstraZeneca vaccines. SARS-CoV-2 infection posed a significantly greater risk for BP than SARS-CoV-2 vaccination. © 2023 American Medical Association. All rights reserved.

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Style	Citing Format
MLA	Rafati A, et al.. "Association of Sars-Cov-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-Analysis." JAMA Otolaryngology - Head and Neck Surgery, vol. 149, no. 6, 2023, pp. 493-504.
APA	Rafati A, Pasebani Y, Jameie M, Yang Y, Jameie M, Ilkhani S, Amanollahi M, Sakhaei D, Rahimlou M, Kheradmand A (2023). Association of Sars-Cov-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-Analysis. JAMA Otolaryngology - Head and Neck Surgery, 149(6), 493-504.
Chicago	Rafati A, Pasebani Y, Jameie M, Yang Y, Jameie M, Ilkhani S, Amanollahi M, Sakhaei D, Rahimlou M, Kheradmand A. "Association of Sars-Cov-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-Analysis." JAMA Otolaryngology - Head and Neck Surgery 149, no. 6 (2023): 493-504.
Harvard	Rafati A et al. (2023) 'Association of Sars-Cov-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-Analysis', JAMA Otolaryngology - Head and Neck Surgery, 149(6), pp. 493-504.
Vancouver	Rafati A, Pasebani Y, Jameie M, Yang Y, Jameie M, Ilkhani S, et al.. Association of Sars-Cov-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-Analysis. JAMA Otolaryngology - Head and Neck Surgery. 2023;149(6):493-504.
BibTex	@article{ author = {Rafati A and Pasebani Y and Jameie M and Yang Y and Jameie M and Ilkhani S and Amanollahi M and Sakhaei D and Rahimlou M and Kheradmand A}, title = {Association of Sars-Cov-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-Analysis}, journal = {JAMA Otolaryngology - Head and Neck Surgery}, volume = {149}, number = {6}, pages = {493-504}, year = {2023} }
RIS	TY - JOUR AU - Rafati A AU - Pasebani Y AU - Jameie M AU - Yang Y AU - Jameie M AU - Ilkhani S AU - Amanollahi M AU - Sakhaei D AU - Rahimlou M AU - Kheradmand A TI - Association of Sars-Cov-2 Vaccination or Infection With Bell Palsy: A Systematic Review and Meta-Analysis JO - JAMA Otolaryngology - Head and Neck Surgery VL - 149 IS - 6 SP - 493 EP - 504 PY - 2023 ER -

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