Epidemiology and Clinical Characteristics of Meningitis Following COVID-19 Vaccinations: A Systematic Review
Mohamed S.A. Shehata1, Amany Mahfouz2, Hossam Tharwat Ali3, Abdelmonem Siddiq4, Aya Mustafa Al Mawla 5, Mostafa Meshref6
1Neurology Department, Nasr City Insurance Hospital, Faculty of Medicine, Zagazig University, Egypt, 2Faculty of Medicine, Kafrelsheikh University, Egypt, 3Qena Faculty of Medicine, South Valley University, Egypt, 4Faculty of Pharmacy, Mansoura University, Egypt, 5Faculty of Medicine, Jordan university of science and technology, Jordan, 6Al-Azhar University, Cairo
Objective:
We conducted the current study to provide a comprehensive overview of the current evidence on the occurrence, classifications, clinical characteristics, management, and prognosis of meningitis following COVID-19 vaccination.
Background:
Vaccines are crucial in combating infectious disease outbreaks, including coronavirus disease
2019 (COVID-19). Global efforts led to the rapid development and widespread administration of COVID-19 vaccines. Despite rare adverse events, such as Guillain–Barré syndrome, myelitis, and encephalitis, cases of COVID-19 vaccine-related meningitis are infrequent.
Design/Methods:
We systematically searched PubMed, Scopus, and Web of Science until March 2023 for studies on meningitis following COVID-19 vaccinations. Two reviewers screened the studies independently, resolving discrepancies with a third reviewer. We extracted data on patient demographics (age and gender), COVID-19 vaccine type and dosage, meningitis occurrence, time between vaccination and symptom onset, meningitis-related neurological and non-neurological symptoms, cerebrospinal fluid analysis, relevant lab and imaging results, diagnosis, and treatment outcomes.
Results:
This review included 26 records involving 31 patients. The mean patient age was 44.29 ± 19.48 years, with 18 females and 13 males. Aseptic meningitis was seen in 45.2% of cases, varicella-zoster virus (VZV) meningitis in 38.7%, aseptic meningoencephalitis in 9.7%, and Myelin oligodendrocyte glycoprotein antibody-associated disease meningitis in two patients. Meningitis occurred more frequently after BNT162b2 vaccination (67.7%), followed by ChAdOx1 nCoV-19 vaccine (22.6%), Sinovac inactivated vaccine, and m-RNA 1273 vaccine. However, there was no statistically significant association between the type of COVID-19 vaccine and the type of meningitis (p= 0.197). Neurological symptoms were reported in 22 and 7 patients after the first and second vaccine doses, respectively.
Conclusions:
Aseptic meningitis (45.2%) and VZV meningitis (38.7%) were the most prevalent types of meningitis following COVID-19 vaccines. Of note, the benefits of vaccination with these vaccines still outweigh the risks. Efforts to develop better vaccines with limited adverse effects and the capacity to prevent transmission must continue.