SARS-CoV-2-associated Guillain-Barre syndrome is not infrequent

Abstract

Dear Editor, We read with interest the review article by Medeiros et al. 1 about patients with SARS-CoV-2-associated Guillain-Barre syndrome (SAG) collected via a search of various databases. It was found that the main manifestations of SAG were fever, coughing, dyspnea, sore throat, ageusia, anosmia, and respiratory failure, in addition to paresthesias of the upper and lower limbs, quadruparesis, facial diplegia, areflexia, asthenia, mastoid pain, acute ataxia, fatigue, numbness, dysphagia, and moderate low back pain 1 . It was concluded that SARS-CoV-2 can trigger GBS 1 . This study is appealing but raises concerns that require discussion.We do not agree with the notion that only few studies on the topic SAG are available as mentioned in the abstract and the discussion 1 . In a recent review about SAG, collecting available data until the end of July 2021, 120 articles reporting 300 patients with SAG were retrieved (Finsterer, submitted). The age of these patients ranged between 7 and 94 years. There was male preponderance. Latency between the onset of COVID-19 and SAG ranged between -10 and 90 days. Acute inflammatory demyelinating polyneuropathy (AIDP) was diagnosed in 171 patients, acute, motor axonal neuropathy (AMAN) in 24, and acute, motor, and sensory axonal neuropathy (AMSAN) in 16 patients. Intravenous immunoglobulins (IVIGs) were given to 241 patients, plasmapheresis to 28 patients, and steroids to 7 patients. A total of 59 patients were in need of artificial ventilation. Complete recovery was achieved only in 42 cases and partial recovery in 163 cases. Notably, 17 patients died.