{"doi":"10.1093/braincomms/fcae448","title":"Vaccination prior to SARS-CoV-2 infection does not affect the neurologic manifestations of long COVID","abstract":"Abstract Persistent symptoms after COVID-19 constitute the long COVID syndrome, also called post-acute sequelae of SARS-CoV-2 infection (PASC). COVID-19 vaccines reduce the gravity of ensuing SARS-CoV-2 infections. However, whether vaccines also have an impact on PASC remain unknown. We investigated whether vaccination prior to infection alters the subsequent neurologic post-acute sequelae of SARS-CoV-2 infection (Neuro-PASC). We studied prospectively the first consecutive 200 post-hospitalization Neuro-PASC (PNP) and 1100 non-hospitalized Neuro-PASC (NNP) patients evaluated at our neuro-COVID-19 clinic between May 2020 and January 2023. Among PNP patients, 87% had a pre-vaccination infection and 13% had a breakthrough infection post-vaccination. Among the NNP patients, 70.7% had a pre-vaccination infection and 29.3% had a breakthrough infection. Both PNP and NNP breakthrough infection patients had more frequent pre-existing depression/anxiety than their respective pre-vaccination infection groups, and NNP breakthrough infection patients also had more frequent comorbidities of headache, lung and gastrointestinal diseases than the NNP pre-vaccination infection group. An average of 10 months after symptom onset, the three most common neurological symptoms for PNP patients were brain fog (86.5%), numbness/tingling (56.5%) and headache (56.5%). Of all Neuro-PASC symptoms, PNP breakthrough infection more frequently reported anosmia compared to PNP pre-vaccination infection patients (69.2 versus 37.9%; P = 0.005). For NNP patients, the three most common neurological symptoms were brain fog (83.9%), headache (70.9%) and dizziness (53.8%). NNP pre-vaccination infection reported anosmia (56.6 versus 39.1%; P < 0.0001) and dysgeusia (53.3 versus 37.3%; P < 0.0001) more frequently than breakthrough infection patients. NNP breakthrough infection more frequently reported dizziness compared to NNP pre-vaccination infection patients (61.5 versus 50.6%; P = 0.001). Both PNP and NNP patients had impaired quality-of-life in cognitive, fatigue, sleep, anxiety and depression domains with no differences between pre-vaccination infection and breakthrough infection groups. PNP patients performed worse on National Institutes of Health Toolbox tests of processing speed, attention, executive function and working memory than a US normative population whereas NNP patients had lower results in processing, speed, attention and working memory, without differences between pre-vaccination infection and breakthrough infection groups. These results indicate that vaccination prior to SARS-CoV-2 infection does not affect the neurologic manifestations of long COVID in either PNP or NNP patients. Minor differences in neurologic symptoms between pre-vaccination infection and breakthrough infection groups may be caused by SARS-CoV-2 strains evolution. Patients developing Neuro-PASC after breakthrough infection have a higher burden of comorbidities, highlighting different risk factors warranting targeted management.","journal":"Brain Communications","year":2024,"id":428487,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9641,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1030403,"name":"Tracey Singer","orcid":null,"position":1,"is_corresponding":false},{"id":749655,"name":"Aditi Venkatesh","orcid":"0000-0001-6933-6504","position":2,"is_corresponding":false},{"id":1209986,"name":"Natasha A. Choudhury","orcid":"0000-0002-4321-7344","position":3,"is_corresponding":false},{"id":1030400,"name":"Gina S. Perez Giraldo","orcid":null,"position":4,"is_corresponding":false},{"id":1030404,"name":"Millenia Jimenez","orcid":null,"position":5,"is_corresponding":false},{"id":1029910,"name":"Janet L. Miller","orcid":"0000-0002-2292-5501","position":6,"is_corresponding":false},{"id":865035,"name":"Melissa Lopez","orcid":"0000-0003-4020-7092","position":7,"is_corresponding":false},{"id":903246,"name":"Barbara A. Hanson","orcid":null,"position":8,"is_corresponding":false},{"id":1210525,"name":"Aasheeta Parikh Bawa","orcid":null,"position":9,"is_corresponding":false},{"id":282272,"name":"Ayush Batra","orcid":"0000-0002-4783-5801","position":10,"is_corresponding":false},{"id":366288,"name":"Eric M. Liotta","orcid":"0000-0003-3182-585X","position":11,"is_corresponding":false},{"id":421942,"name":"Igor J. Koralnik","orcid":"0000-0001-6836-1468","position":12,"is_corresponding":false},{"id":57463,"name":"Shreya Mukherjee","orcid":"0009-0006-5431-3338","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":null,"created_at":"2026-07-19T01:58:57.592578Z","pmid":"39777257","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}