Incidence of Bell’s palsy after coronavirus disease (COVID-19) vaccination: a systematic review and meta-analysis

Objective: To estimate the pooled incidence of Bell’s palsy after COVID-19 vaccination. Methods: PubMed, Scopus, EMBASE, Web of Science, and Google Scholar were searched by 2 independent researchers. We also searched the grey literature including references of the references and conference abstracts. We extracted data regarding the total number of participants, first author, publication year, the country of origin, sex, type of vaccines, and the number of patients who developed Bell’s palsy after COVID-19 vaccination. Results: The literature search revealed 370 articles, subsequently deleting duplicates 227 remained. After careful evaluation of the full texts, 20 articles remained for meta-analysis. The most commonly administered vaccines were Pfizer followed by Moderna.In total, 4.54e+07 individuals received vaccines against COVID-19, and 1739 cases developed Bell’s palsy. In nine studies, controls (individuals without vaccination) were enrolled. The total number of controls was 1 809 069, of whom 203 developed Bell’s palsy. The incidence of Bell’s palsy after COVID-19 vaccines was ignorable. The odds of developing Bell’s palsy after COVID-19 vaccines was 1.02 (95% CI: 0.79-1.32) (I2 = 74.8%, P < .001). Conclusion: The results of this systematic review and meta-analysis show that the incidence of peripheral facial palsy after COVID-19 vaccination is ignorable and vaccination does not increase the risk of developing Bell’s palsy. Maybe, Bell’s palsy is a presenting symptom of a more severe form of COVID-19, so clinicians must be aware of this. Resumen: Objetivo: Estimar la incidencia agrupada de la parálisis de Bell después de la vacunación contra el COVID-19. Métodos: Realizamos búsquedas sistemáticas (dos investigadores independientes) en PubMed, Scopus, EMBASE, Web of Science y Google Scholar. También se realizaron búsquedas en la literatura gris, incluidas las referencias de las referencias y los resúmenes de congresos. Extrajimos datos sobre el número total de participantes, el primer autor, el año de publicación, el país de origen, femenino/masculino, el tipo de vacunas y el número de pacientes que desarrollaron parálisis de Bell después de la vacunación contra el COVID-19. Resultados: La búsqueda bibliográfica reveló 370 artículos, eliminando posteriormente los duplicados que quedaban 227. Después de una cuidadosa evaluación de los textos completos, quedaron veinte artículos para el metanálisis. Las vacunas más comúnmente administradas fueron Pfizer