Guillain–Barré syndrome associated with COVID-19: A systematic review

Pimentel, Vitória; Luchsinger, V. W.; Carvalho, Gabriel Leal; Alcará, Allan Marinho; Esper, Nathália Bianchini; Marinowic, Daniel Rodrigo; Zanirati, Gabriele; Costa, Jaderson Costa da

doi:10.1016/j.bbih.2022.100578

Cited by 28 publications

(39 citation statements)

References 42 publications

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“…Careful surgical positioning and attention to repositioning in longer-duration surgeries should be implemented. COVID-19 is also a known risk factor for Guillain-Barre syndrome, with the most common subtype being acute inflammatory demyelinating polyradiculoneuropathy, which may cause respiratory muscle weakness in severe forms and further exacerbate preexisting decreased pulmonary function related to COVID-19 infection [18 ▪ ]. In the perioperative setting, this may both impact the decision for intraoperative intubation as well as alter the criteria and setting for postoperative extubation.…”

Section: Neurologic Considerationsmentioning

confidence: 99%

Lingering effects of COVID-19 in the care of perioperative patients

Jia,

Navare,

Hoyler

2024

Current Opinion in Anaesthesiology

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Purpose of review Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can lead to organ dysfunction and clinical symptoms beyond the acute infection phase. These effects may have significant implications for the management of perioperative patients. The purpose of this article is to provide a systems-based approach to the subacute and chronic effects of SARS-CoV-2 that are most relevant to anesthesiology practice. Recent findings In 2024, COVID-19 remains a concern for anesthesiologists due ongoing new infections, evolving viral strains, and relatively low rates of booster vaccination in the general population. A growing body of literature describes the post-COVID-19 syndrome in which patients experience symptoms more than 12 weeks after acute infection. Recent literature describes the lingering effects of SARS-CoV-2 infection on all major organ systems, including neurologic, pulmonary, cardiovascular, renal, hematologic, and musculoskeletal, and suggests an increased perioperative mortality risk in some populations. Summary This review offers anesthesiologists an organ system-based approach to patients with a history of COVID-19. Recognizing the long-term sequelae of SARS-CoV-2 infection can help anesthesiologists to better evaluate perioperative risk, anticipate clinical challenges, and thereby optimize patient care.

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Section: Neurologic Considerationsmentioning

confidence: 99%

Lingering effects of COVID-19 in the care of perioperative patients

Jia,

Navare,

Hoyler

2024

Current Opinion in Anaesthesiology

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“…Conversely, neurological dysfunction associated with autoimmunity was also reported. Cases included ADEM (Nabizadeh et al, 2023), Guillain-Barré syndrome (GBS; Pimentel et al, 2023), MS and NMOSD onset (Harel et al, 2023), encephalitis (Nabizadeh et al, 2022), among others. As COVID-19 became widespread worldwide, those manifestations turned into a public health concern.…”

Section: Introductionmentioning

confidence: 99%

A case study: ADEM-like lesions as a first clinical event in highly active multiple sclerosis

Costa,

Raposo-Vedovi,

Fernandes

et al. 2024

Preprint

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Introduction: Multiple sclerosis is an autoimmune cause of neurological disability. Among its risk factors, it may be related to viral triggers. The advent of COVID-19 raises concern as a novel cause of CNS autoimmunity, which may be a response to virus antigens. In this context, we present a case of highly active multiple sclerosis onset two weeks after SARS-CoV2 mRNA vaccination. Case description: A young woman had lower limb paresthesia which quickly evolved into tetraplegia. She had oligoclonal bands on CSF, with cervical myelitis and a brain MRI suggestive of acute disseminated encephalomyelitis. The highest EDSS observed was 9.5 and sustained remission was only achieved after natalizumab treatment was initiated, reaching EDSS 1.5. Discussion: Case evaluation involved the use of plasma biomarkers. While neurodegeneration biomarkers NfL, GFAP, Tau and UCHL1 decreased, the subject appeared to have sustained inflammatory activity with increased CRP, CD-14, TLR4, IL-1β and IL-17A even after remission. Neuroprotective cytokine TGFβ content was also lower. The existence of blackhole-like lesions at first MRI evaluation and individual risk factors in the form of TNF (rs1800629), SOD2 (rs4880) and FCGR2A (rs1801274) gene variants suggest previous subclinical disease, being impossible to define vaccination as a causative factor. Furthermore, review of previously reported cases of MS onset after a SARS-CoV2 vaccine showed a total of 28 cases, with a mean EDSS of 2.44 at the time of worst disability and highly heterogenous exposition intervals. The highest reported EDSS was 3.5. At least 17 subjects achieved remission. Conclusions: Atypical presentations of MS at onset present a challenge which may benefit from precision assays. SARS-CoV2 vaccination appears as a confounder in this case, its relationship with MS activation seeming to be a rare event with low morbidity. The authors understand this case study illustrates how, in an epidemiological standpoint, vaccination benefits still outweigh the risks perceived.

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“…Late consequences of COVID-19 may include stroke and impaired level of consciousness [4,5]. According to current knowledge, Guillain-Barré syndrome (GBS) can also be associated with COVID-19 infection [6].…”

Section: Introductionmentioning

confidence: 99%

Guillain-Barré syndrome associated with COVID-19 infection – Case Report and literature review

Paluch¹,

Biedroń²,

Kaczmarska³

et al. 2023

J Pre Clin Clin Res.

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Guillain-Barré syndrome (GBS) is a rare, acute immune-mediated polyradiculoneuropathy that accounts for an estimated 100,000 new cases annually worldwide. The typical clinical manifestations of the disease are progressive, ascending paralysis, classically involving bilateral upper and lower extremities. In most patients, the acute onset of neurological symptoms is preceded by an infectious respiratory or gastrointestinal illness. The case is presented of a 50-year-old man who was transferred to an intensive care unit from the Department of Neurology, due to a worsening state of bilateral weakness of limbs, with symptoms of respiratory failure and hemodynamic instability. Guillain-Barré syndrome was diagnosed in the previous clinic on the basis of the typical symptoms and results of cerebrospinal fluid, in which albuminocytological dissociation was detected. Furthermore, two weeks previously, the patient had been infected with COVID-19.

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Guillain–Barré syndrome associated with COVID-19: A systematic review

Cited by 28 publications

References 42 publications

Lingering effects of COVID-19 in the care of perioperative patients

Lingering effects of COVID-19 in the care of perioperative patients

A case study: ADEM-like lesions as a first clinical event in highly active multiple sclerosis

Guillain-Barré syndrome associated with COVID-19 infection – Case Report and literature review

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