Bell’s palsy (idiopathic facial nerve palsy) has an annual incidence of 15 to 30 cases per 100,000 people. This study aims to assess the effect of Covid and Covid vaccination on this incidence using a large database. Authors used TriNetX, the global federated health research network providing access to electronic medical records across large healthcare organisations in the US. They had access to around a hundred million patients. They searched for Bell’s palsy (BP), Covid and Covid vaccinations in this large cohort. Authors compared two periods: 2016–2020 and 2020–2024. They accounted for possible confounding factors when comparing the groups. Authors reported that there was an overall a significant increase in the number of BP cases between 2016 and 2024. There was also a significant positive difference when the rate of acceleration of incidence increase was compared between pre-pandemic and pandemic years. There was an increase in the prevalence of BP in the pandemic years in both Covid and non-Covid patients. However, the amount of increase was higher in Covid patients. Both vaccinated and unvaccinated groups noted an increase in cases of BP. However, the rate of increase was sharper in unvaccinated patients. Authors commented that the previous literature showed inconclusive results when investigating the effects of the vaccine on BP incidence. They tried to explain the potential reasons behind the increase reported in their paper. They also pointed out some limitations such as the lack of generalisability to other countries and the limitations of the data set that they used. The study highlights the effect of Covid vaccination on reducing the incidence of BP. It also demonstrates the importance of asking about recent Covid infections and vaccination status in patients presenting with BP.
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