Post-COVID-19 Vaccination Meningitis and Meningoencephalitis: A Systematic Review of Case Series and Case Reports

Mahdieh Taiyeb Khosroshahi Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran;
Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran;

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Sana Hamidi Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran;
Tabriz USERN Office, Universal Scientific Education and Research Network (USERN), Tabriz, Iran;

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Parisa Kangari Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran;

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Sohrab Gharakhanlou Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran;
Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran;

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Zahra Hamidi Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran;

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Abolfazl Jafari-Sales Department of Microbiology, Faculty of Medical Sciences, Islamic Azad University, Kazerun, Iran;

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Ali Shamekh Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran;
Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;
Department of Virology, Tabriz University of Medical Sciences, Tabriz, Iran

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Hossein Bannazadeh Baghi Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;
Department of Virology, Tabriz University of Medical Sciences, Tabriz, Iran

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Soroush Morsali Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran;
Tabriz USERN Office, Universal Scientific Education and Research Network (USERN), Tabriz, Iran;

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Meningitis and meningoencephalitis, as inflammatory diseases of the brain parenchyma, are serious events reported sporadically after coronavirus disease 2019 (COVID-19) vaccination. However, there is a lack of systematic reviews consolidating these reported cases. By using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search was conducted across PubMed, Scopus, Embase, and Web of Science databases. All case reports and series discussing the emergence of meningitis and meningoencephalitis after COVID-19 vaccination were included and evaluated using the Joanna Briggs Institute critical appraisal tool. Out of 967 records, 27 studies with 31 patients were eventually included. The most commonly reported symptoms were headaches and fever. About one-third of the patients exhibited positive meningeal signs. Most of the findings in the computed tomography scans and magnetic resonance images revealed no significant changes or enhancement in the leptomeninges. Cerebrospinal fluid analysis dominantly suggested aseptic meningitis, and about 80.6% of the patients experienced a full recovery. After a detailed review of the reported cases, further research is needed to establish a definitive correlation between meningitis and COVID-19 vaccination on a larger scale.

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Author Notes

Financial support: The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number 73521).

Authors’ contributions: Conceptualization, S. Morsali and M. T. Khosroshahi; systematic search and study selection, S. Morsali, S. Hamidi, P. Kangari, M. T. Khosroshahi, A. Jafari-Sales, and Z. Hamidi; data extraction, risk of bias assessment, preparation of the tables, and writing of the first draft of the manuscript, M. T. Khosroshahi, S. Morsali, S. Gharakhanlou, S. Hamidi, and Z. Hamidi; supervision and critical editing of the manuscript, S. Morsali and S. Gharakhanlou; critical review and editing of the manuscript, A. Shamekh. All authors approved the final version for submission.

Data availability: No new data were created or analyzed in this study. The search strategy and data extraction table are available in the supplemental files.

Current contact information: Mahdieh Taiyeb Khosroshahi and Sohrab Gharakhanlou, Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran, Tabriz, East Azerbaijan, Iran, E-mails: mtayebkhosroshahi@gmail.com and sohrabgrxnl@gmail.com. Sana Hamidi, Zahra Hamidi, Ali Shamekh, and Soroush Morsali, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran, E-mails: hamidisana01@gmail.com, zahra.hamidi9898@gmail.com, shamekh98@gmail.com, and soroosh19720@gmail.com. Parisa Kangari, Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran, E-mail: pk_biology@yahoo.com. Abolfazl Jafari-Sales and Hossein Bannazadeh Baghi, Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, E-mails: a.jafari_1392@yahoo.com and hb.zadeh@gmail.com.

Address correspondence to Hossein Bannazadeh Baghi, Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, P.O. Box 5165665931, East Azerbaijan, Iran, E-mail: hbannazadeh@tbzmed.ac.ir or Soroush Morsali, Student Research Committee, Tabriz University of Medical Sciences, P.O. Box 5167867567, East Azerbaijan, Iran. E-mail: soroosh19720@gmail.com
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