Iran University of Medical Sciences & Health Services

TUESDAY, May 2, 2023 -- Incidence of Bell palsy is significantly more common following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection than after receipt of SARS-CoV-2 vaccinations, according to a review published online April 27 in JAMA Otolaryngology-Head & Neck Surgery . Ali Rafati, M.D., from Iran University of Medical Sciences in Tehran, and colleagues conducted a systematic literature review to compare the incidence of Bell palsy in people receiving COVID-19 vaccines versus unvaccinated individuals or placebo recipients. The researchers found that when pooling data from four phase 3 randomized clinical trials, Bell palsy incidence was significantly higher in recipients of COVID-19 vaccines versus placebo recipients (77,525 vaccine recipients versus 66,682 placebo recipients; odds ratio [OR], 3.00; 95 percent confidence interval [CI], 1.10 to 8.18). However, there was no significant increase seen in Bell palsy after administration of messenger RNA SARS-CoV-2 vaccines (eight studies; 13,518,026 doses versus 13,510,701 unvaccinated; OR, 0.70; 95 percent CI, 0.42 to 1.16). There was no significant difference in the incidence of Bell palsy among 22,978,880 first-dose recipients of the Pfizer/BioNTech vaccine versus 22,978,880 first-dose recipients of the Oxford/AstraZeneca vaccine (OR, 0.97; 95 percent CI, 0.82 to 1.15). Furthermore, Bell palsy was significantly more common after SARS-CoV-2 infection (2,822,072) compared with after COVID-19 vaccinations (37,912,410; relative risk, 3.23; 95 percent CI, 1.57 to 6.62). "This study shows evidence for the association between SARS-CoV-2 and Bell palsy; however, this finding does not equate to causality, and further research is required to verify this association and investigate possible mechanisms," the authors write. Abstract/Full Text Posted May 2023 Further Support and Information on COVID-19 COVID-19: Prevention & Investigational Treatments COVID-19 Support Group Coronavirus Disease Guide

Children with certain immunodeficiency diseases carry mutations in genes that regulate the body's immune system against viral infections and they have a higher mortality rate due to COVID-19, according to a new study. Children with certain immunodeficiency diseases carry mutations in genes that regulate the body's immune system against viral infections and they have a higher mortality rate due to COVID-19. This is according to a study by researchers from Karolinska Institutet in Sweden, published in the Journal of Allergy and Clinical Immunology. Most children infected with the SARS-CoV-2 coronavirus develop a mild illness or show no symptoms at all. But for a small percentage, serious complications may develop. "Mortality is much higher among children with primary immunodeficiency diseases infected with SARS-CoV-2. Our results indicate that basic immunological examination and genetic analysis should be conducted in children with severe COVID-19 or multi-inflammatory syndrome (MIS-C). The clinicians will then be able to help these children with more precise therapies based on their genetic changes,"says Qiang Pan-Hammarström, professor at the Department of Biosciences and Nutrition, Karolinska Institutet, who led the study. How the infection affects patients with primary immunodeficiency diseases, i.e. hereditary and congenital diseases of the immune system, is controversial. Even among these patients, some suffer from severe COVID-19 while others experience mild or no symptoms. To investigate this more closely, and try to find genetic explanations for severe forms of COVID-19, researchers from Karolinska Institutet have studied young patients with primary immunodeficiency diseases (also called inborn errors of immunity, IEI) who developed severe or critical SARS-CoV-2 infection. Genetic and immunological analyses were performed. "Our results clarify the molecular mechanism of these immune diseases, which opens up the possibility of developing a more targeted therapy. The knowledge acquired from the study also allows us to develop better strategies for the treatment and prevention of severe COVID-19 disease in these patients," says Qiang Pan-Hammarström. The study included 31 children aged five months to 19 years. All children had some type of primary immunodeficiency disease without a molecular diagnosis and suffered from severe or critical COVID-19. Participants were recruited from August to September 2020 in Iran. None of the children were vaccinated against COVID-19. Eleven of the children, more than one-third, died of complications from the infection. Five children, 16 per cent, met the criteria for multi-inflammatory syndrome, MIS-C. Some of the children lacked antibodies to the coronavirus. "This suggests that many children with this type of immune disease cannot produce antiviral antibodies and therefore would not have the full benefit of vaccination," says Hassan Abolhassani, assistant professor at the Department of Biosciences and Nutrition, Karolinska Institutet, and the study's first author. Genetic analyses showed that more than 90 per cent of the participants, 28 children, had mutations in genes that are important for our immune defense, and that could explain their immunodeficiency. An important mechanism was mutations that affect proteins that regulate the immune system during virus infection, known as interferons. The analyses of the patients' immune responses showed that children with MIS-C had immunological profiles that differ from the profiles of children with primary immunodeficiency but without MIS-C. The study also includes a literature review, where the researchers globally found reports of approximately 1,210 patients with primary immunodeficiency disease and COVID-19. About 30 per cent of them were children. The mortality rate among children with primary immunodeficiency disease and COVID-19 was more than eight per cent, compared with about 0.01 per cent among children in the general population. The study is limited to severe cases of COVID-19, infected with the original strain of the virus, and non-vaccinated children. Further studies are needed to evaluate the importance of different virus variants and vaccines in this patient group. The study was conducted within the research consortium ATAC, funded by the European Commission in response to the COVID-19 pandemic and coordinated by Karolinska Institutet. Collaboration with Uppsala University, Tehran University of Medical Sciences (Iran), Iran University of Medical Sciences, Ahvaz Jundishapur University of Medical Sciences (Iran), North Khorasan University of Medical Sciences (Iran), Howard Hughes Medical Institute (USA), Rockefeller University (USA) and Necker Hospital for Sick Children (France) were also crucial for the implementation of the study. The study was also funded by the Swedish Research Council and the Knut and Alice Wallenberg Foundation.