Has Coranavirus Disease 2019 Changed the Incidence and Outcome of Bell's Palsy?

Objectives: (1) To determine whether the incidence of Bell's Palsy (BP) increased during the pandemic. (2) To investigate whether the outcomes of patients with BP and COVID-19 infection or vaccination differ from those in the pre-pandemic era. Patients with BP were studied in 2 periods retrospe...

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Bibliographic Details
Published in:	Journal of International Advanced Otology Vol. 20; no. 1; pp. 19 - 25
Main Authors:	Lassaletta, Luis, Sánchez-Cuadrado, Isabel, Mato-Patino, Teresa, Peñarrocha, Julio, Angélica Rivera-Núñez, María, María Torres Santos-Olmo, Rosario, Gavilán, Javier, Manuel Morales-Puebla, José, Group, Covid Orl Hulp Collaborative
Format:	Journal Article
Language:	English
Published:	Turkey AVES 01-01-2024 Mediterranean Society for Otology and Audiology European Academy of Otology and Neurotology and the Politzer Society
Subjects:	Asymmetry Bell Palsy - epidemiology Bells palsy Coronaviruses COVID-19 - epidemiology COVID-19 Vaccines Disease DNA polymerases Emergency medical care Enzyme-linked immunosorbent assay Enzymes Epidemics Facial Paralysis Hospitals Humans Immunoglobulin G Incidence Infections Medical research Medicine, Experimental Original Otolaryngology Pandemics Paralysis Patient outcomes Polymerase chain reaction Prospective Studies Retrospective Studies SARS-CoV-2 Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Spain Steroids Symmetry Vaccination Variables Spain
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Summary:	Objectives: (1) To determine whether the incidence of Bell's Palsy (BP) increased during the pandemic. (2) To investigate whether the outcomes of patients with BP and COVID-19 infection or vaccination differ from those in the pre-pandemic era. Patients with BP were studied in 2 periods retrospectively (March 2021-March 2022 and August 2018-August 2019). A prospective study from March 2021 to March 2022 was also performed. Primary outcome was grade ≤Ⅱ in the House-Brackmann (HB) and/or >70 in the Sunnybrook facial grading system (SFGS) scales at the 12-week visit. Reverse transcriptase polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and enzyme-linked immunosorbent assay-based SARS-CoV-2 immuonoglobulin G (IgG) test (blood) were measured. About 162 and 196 patients with BP were identified between March 2021 and March 2022 and August 2018 and August 2019, respectively. Forty-seven patients (29%) entered the prospective study; 85% had HB grades I or II, while 92% had an SFGS score of 71-100 at the last visit. Only 3 patients (6.5%) had a positive PCR during the initial episode, whereas 35 patients (77%) had positive IgG SARS-CoV-2. There was no association between positive PCR and facial function outcomes. Of the 162 patients, 105 (67%) had received COVID-19 vaccine. In 23 of them (22%), the paralysis appeared within the first 30 days after a vaccine dose. Coronavirus disease 2019 did not increase the incidence of BP. A direct association between the coronavirus and BP outcome cannot be established. The considerable number of patients developing BP within the first month suggests a possible association between COVID-19 vaccines and BP.
Bibliography:	Collaborators listed at the end of the manuscript. Cite this article as: Lassaletta L, Sanchez-Cuadrado I, Mato-Patino T, et al. Has coronavirus disease 2019 changed the incidence and outcome of bell’s palsy? J Int Adv Otol. 2024;20(1):19-25. ORCID iDs of the authors: L.L. 0000-0002-8260-4523, I.S.-C. 0000-0001-6687-4913, T.M.-P. 0000-0002-9992-0215, J.P. 0000-0003-1442-5002, M.A.R.-N. 0000-0003-1086-2299, R.M.T.S.-O. 0000-0002-8479-3671, J.G. 0000-0002-9357-5932, J.M.M.-P. 0000-0003-3976-4019.
ISSN:	1308-7649 2148-3817
DOI:	10.5152/iao.2024.231254