COVID-19 may induce Guillain–Barré syndrome

Camdessanché, Jean‐Philippe; Morel, J.; Pozzetto, Bruno; Paul, Stéphane; Tholance, Yannick; Botelho-Nevers, Élisabeth

doi:10.1016/j.neurol.2020.04.003

Cited by 183 publications

(177 citation statements)

References 3 publications

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“…5,7,9 Reports are now emerging of similar associations with COVID-19 and GBS, and with GBS variants, including the Miller-Fisher syndrome. [41][42][43][44][45][46] The largest series to date, describes five patients. 47 In this series, all patients developed GBS 5 to 10 days following COVID-19 symptom onset.…”

Section: Post-infectious and Immune-mediated Complications Of Sars-cov-2mentioning

confidence: 99%

COVID‐19: A Global Threat to the Nervous System

Koralnik

Tyler

2020

Annals of Neurology

409

403

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In less than 6 months, the severe acute respiratory syndrome‐coronavirus type 2 (SARS‐CoV‐2) has spread worldwide infecting nearly 6 million people and killing over 350,000. Initially thought to be restricted to the respiratory system, we now understand that coronavirus disease 2019 (COVID‐19) also involves multiple other organs, including the central and peripheral nervous system. The number of recognized neurologic manifestations of SARS‐CoV‐2 infection is rapidly accumulating. These may result from a variety of mechanisms, including virus‐induced hyperinflammatory and hypercoagulable states, direct virus infection of the central nervous system (CNS), and postinfectious immune mediated processes. Example of COVID‐19 CNS disease include encephalopathy, encephalitis, acute disseminated encephalomyelitis, meningitis, ischemic and hemorrhagic stroke, venous sinus thrombosis, and endothelialitis. In the peripheral nervous system, COVID‐19 is associated with dysfunction of smell and taste, muscle injury, the Guillain‐Barre syndrome, and its variants. Due to its worldwide distribution and multifactorial pathogenic mechanisms, COVID‐19 poses a global threat to the entire nervous system. Although our understanding of SARS‐CoV‐2 neuropathogenesis is still incomplete and our knowledge is evolving rapidly, we hope that this review will provide a useful framework and help neurologists in understanding the many neurologic facets of COVID‐19. ANN NEUROL 2020;88:1–11 ANN NEUROL 2020;88:1–11

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Section: Post-infectious and Immune-mediated Complications Of Sars-cov-2mentioning

confidence: 99%

COVID‐19: A Global Threat to the Nervous System

Koralnik

Tyler

2020

Annals of Neurology

409

403

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“…reported. [4][5][6][7][8] All patients had fever and respiratory symptoms 5 to 10 days before the onset of the neurological symptoms, one of them had ongoing fever and poor general condition. The electrodiagnostic findings were consistent with an axonal variant of GBS in four out of nine patients.…”

Section: Nine Cases Of Gbs In Patients With Covid-19 Have Been Recentlymentioning

confidence: 99%

Guillain‐Barré syndrome during SARS‐CoV‐2 pandemic: A case report and review of recent literature

Scheidl¹,

Canseco²,

Hadji-Naumov³

et al. 2020

J Peripheral Nervous Sys

186

191

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Acute demyelinating inflammatory polyneuropathy (AIDP) is the most common type of Guillain-Barré syndrome (GBS) in Europe, following several viral and bacterial infections. Data on AIDP-patients associated with SARS-CoV-2 (coronavirus-2) infection are scarce. We describe the case of a 54-years-old Caucasian female patient with typical clinical and electrophysiological manifestations of AIDP, who was reported positive with PCR for SARS-CoV-2, 3 weeks prior to onset of the neurological symptoms. She did not experience a preceding fever or respiratory symptoms, but a transient loss of smell and taste. At the admission to our neurological department, a progressive proximally pronounced paraparesis, areflexia, and sensory loss with tingling of all extremities were found, which began 10 days before. The modified Erasmus Giullain-Barré Syndrome outcome score (mEGOS) was 3/9 at admission and 1/12 at day 7 of hospitalization. The electrophysiological assessment proved a segmental demyelinating polyneuropathy and cerebrospinal fluid examination showed an albuminocytologic dissociation. The neurological symptoms improved significantly during treatment with immunoglobulins. Our case draws attention to the occurrence of GBS also in patients with COVID-19 (coronavirus disease 2019), who did not experience respiratory or general symptoms. It emphasizes that SARS-CoV-2 induces immunological processes, regardless from the lack of prodromic symptoms. However, it is likely that there is a connection between the severity of the respiratory syndrome and further neurological consequences.

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“…A total of 18 patients reported in 14 papers [12][13][14][15][16][17][18][19][20][21][22][23][24][25] were included in this review. The 14 selected papers consisted of 13 case reports and one series.…”

Section: Study Selectionmentioning

confidence: 99%

“…Table 4 shows the diagnostic ancillary tests, outcome and treatment. Fourteen cases were from Europe [12,[16][17][18][19][20][22][23][24][25], one from the USA [13], one from China [14], one from Iran [15] and one from Morocco [21]. Ten patients were males whilst eight were females.…”

Section: Study Selectionmentioning

confidence: 99%

Guillain–Barré syndrome associated with SARS‐CoV‐2 infection. A systematic review

Sanctis

Doneddu

Viganó

et al. 2020

Euro J of Neurology

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Guillain-Barr e syndrome (GBS) incidence can increase during outbreaks of infectious illnesses. A few cases of GBS associated with coronavirus disease 2019 (COVID-19) infection have been reported. The aim was to identify specific clinical features of GBS associated with COVID-19. PubMed, Embase and Cochrane were searched from 1 November 2019 to 17 May 2020 and included all papers with full text in English, Spanish, French or Italian, reporting original data of patients with GBS and COVID-19. Data were extracted according to a predefined protocol. A total of 18 patients reported in 14 papers were included in this review. All the patients were symptomatic for COVID-19, with cough and fever as the most frequently reported symptoms. The interval between the onset of symptoms of COVID-19 and the first symptoms of GBS ranged from À8 to 24 days (mean 9 days; median 10 days). Most of the patients had a typical GBS clinical form predominantly with a demyelinating electrophysiological subtype. Mechanical ventilation was necessary in eight (44%) patients. Two (11%) patients died. Published cases of GBS associated with COVID-19 report a sensorimotor, predominantly demyelinating GBS with a typical clinical presentation. Clinical features and disease course seem similar to those observed in GBS related to other etiologies. These results should be interpreted with caution since only 18 cases have been heterogeneously reported so far.

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COVID-19 may induce Guillain–Barré syndrome

Cited by 183 publications

References 3 publications

COVID‐19: A Global Threat to the Nervous System

COVID‐19: A Global Threat to the Nervous System

Guillain‐Barré syndrome during SARS‐CoV‐2 pandemic: A case report and review of recent literature

Guillain–Barré syndrome associated with SARS‐CoV‐2 infection. A systematic review

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