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

Lay Khoon Loo, Omar Salim, Di Liang, Aimee Goel, Salini Sumangala, Ashwin S. Gowda, Brendan Davies, Yusuf A. Rajabally

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)233-237
Number of pages5
JournalMuscle and Nerve
Issue number2
Early online date16 Nov 2021
Publication statusPublished - Feb 2022

Bibliographical note

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.


  • Guillain-Barré syndrome
  • chronic inflammatory demyelinating polyradiculoneuropathy
  • polyradiculoneuropathy


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