Guillain-Barre syndrome: An autoimmune disorder post-COVID-19 vaccination?

Abstract

SARS-CoV-2 causes Coronavirus Disease 2019 (COVID-19), an infectious condition that can present none or one or more of these symptoms: fever, cough, headache, sore throat, loss of taste and smell, aches, fatigue and musculoskeletal pain. For the prevention of COVID-19, there are vaccines available including those developed by Pfizer, Moderna, Sinovac, Janssen, and AstraZeneca. Recent evidence has shown that some COVID-19-vaccinated individuals can occasionally develop as a potential side effect Guillain-Barre syndrome (GBS), a severe neurological autoimmune condition in which the immune response against the peripheral nerve system (PNS) can result in significant morbidity. GBS had been linked previously to several viral or bacterial infections, and the finding of GBS after vaccination with certain COVID-19, while rare, should alert medical practitioners for an early diagnosis and targeted treatment. Here we review five cases of GBS that developed in different countries after COVID-19 vaccination.

Guillain-Barré Syndrome: A Case Report of Post Covid-19 Vaccination in the Philippines

“…Vaccine-associated GBS is defined as the onset of GBS symptoms within the six-week period after receiving the vaccine (Sejvar et al, 2011). Known COVID-19 vaccines worldwide include Pfizer-BioNTech, Moderna, Oxford Astrazeneca, Johnson and Johnson, and Sinovac (Khan et al, 2022). A systematic review by Shao et al, (2021) found only 17 publications reporting 39 cases of post-vaccination GBS.…”

“…In our patient, the onset of GBS started seven days after his first shot of Sinovac Vaccine, and findings also indicated a strong association between the two. The first case of GBS following COVID-19 vaccination was reported in February 2021 (Khan et al, 2022), with an elderly female from Florida, USA who presented with GBS symptoms two weeks after the first dose of Pfizer vaccine. The patient presented with fatigue and bilateral symmetric weakness of the lower limbs, and CSF analysis indicated albuminocytological dissociation.…”

“…Worldwide, several patients have been reported to experience pain in the vaccination site, to a more serious anaphylactic shock (Salmon et al, 2013). Neurological complications after COVID-19 vaccinations are very rare, and only a few cases have been reported, where an article published February 2021 reported the first case of Guillain-Barré Syndrome (GBS) after the first dose of Pfizer COVID-19 vaccine in Florida (Khan et al, 2022).…”

Clinical and Molecular Characterization of a Rare Case of BNT162b2 mRNA COVID-19 Vaccine-Associated Myositis

“…However, recent studies showed that in autoimmune inflammatory rheumatic diseases (AIIRD), the BNTb262 vaccine could generate immunogenic response in the majority of patients, which raised safety concerns for patients with AIIRDs [ 10 , 11 , 12 ]. Some evidence demonstrated that BNT162b2 could induce the development of Guillain-Barre syndrome (GBS), which is a rare neurological autoimmune disorder of the peripheral nervous system [ 13 , 14 , 15 , 16 , 17 ]. Furthermore, a recent case study reported that the BNT162b2 vaccine induced the development of acute transverse myelitis followed by fatal neurological complications [ 18 ].…”

Pain Adverse Events, Bell’s Palsy, and Guillain-Barré Syndrome Following Vaccination

“…Other rare adverse events like Bell's palsy and Guillain-Barré syndrome (GBS) can occur with causality di cult to assess with frequencies close to background occurrence frequencies [2,3]. GBS has been associated with in uenza [4] and COVID-19 vaccinations [5]. GBS has been reported following Moderna [6][7][8][9][10], P zer BioNTech BNT162b2 [11][12][13][14][15][16][17][18][19], Oxford AstraZeneca ChAdOx1 day [15,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34], Johnson & Johnson/Janssen Ad26.CoV2.S [10,[35][36][37][38][39], Sinopharm [33,34], and Sputnik V [34,40] COVID-19 vaccines.…”