Guillain-Barré syndrome following COVID-19: new infection, old complication?

Padroni, Marina; Mastrangelo, Vincenzo; Asioli, Gian Maria; Pavolucci, Lucia; Abu‐Rumeileh, Samir; Piscaglia, Maria Grazia; Querzani, Pietro; Callegarini, C.; Foschi, Matteo

doi:10.1007/s00415-020-09849-6

Cited by 193 publications

(205 citation statements)

References 10 publications

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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

182

187

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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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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

182

187

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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%

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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“…GBS occurred in 5/1200 (0.4%) patients with COVID-19 in one of the studies [13]. There were six other case report of GBS, one Miller Fisher syndrome, and two polyneuritis cranialis [14,[24][25][26][27][28][29][30]. Interestingly, neurotropism of human coronaviruses has been suggested by in vitro and in vivo studies that showed that certain strains of the viruses could persist in the human CNS by targeting oligodendrocytic and neuroglial cell lines [41].…”

Section: Discussionmentioning

confidence: 99%

“…Thirty-one patients experienced a cerebrovascular complication, with 27 ischemic strokes [11,[19][20][21][22][23], 3 hemorrhagic strokes [11,15,23] and 1 cerebral venous sinus thrombosis [11]. There were 15 patients with GBS [13,14,[24][25][26][27][28][29][30] or its variants, 6 reported as encephalitis [12,18,[31][32][33], one with seizures [34], one with acute hemorrhagic necrotizing encephalopathy [16] one reported as transverse myelitis [35], and one reported as ADEM [36]. Nine of these cases were reported as fatal.…”

mentioning

confidence: 99%

Neurological Complications of COVID-19: A Systematic Review of Literature

Sriwastava

Srivastava

Kataria

et al. 2020

Preprint

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Abstract Background: To study the nature and frequency of occurrence of “significant” neurological complications in coronavirus disease-2019 (COVID-19) via a systematic review of the literature.Methods: We screened all articles resulting from a search of PubMed, Cochrane, Google Scholar and Scopus, using the keywords "COVID-19 and CNS", "SARS-CoV-2 and CNS”, “COVID-19 and neurological manifestation”, “SARS2 and neurological manifestation” and “COVID-19 and Brain” looking for reports of significant neurological manifestations that would potentially have an impact on the outcome.Results: Twenty-six articles met the inclusion criteria. The significant neurological diagnoses reported were stroke, Guillain Barre Syndrome (GBS) and its variants, encephalitis, seizures, acute hemorrhagic necrotizing encephalopathy, acute disseminated encephalomyelitis (ADEM) and transverse myelitis. Although stroke, predominantly ischemic, was observed in ~ 6% of COVID-19 patients from Wuhan, China, mortality in this cohort was 38%. Of the 24 pooled patients with reports of etiology, 17 had large vessel occlusions. GBS occurred in 5/1200 (0.4%) of the COVID-19 cohort from Italy. One of the six reported encephalitis cases, the ADEM case and the report of transverse myelitis do not have data for conclusive diagnosis.Conclusion: The most frequent significant neurological association with COVID-19 is stroke, predominantly ischemic. In a cohort from Wuhan, China, this was as frequent as ~ 6%, with a 38% mortality. Most common reported etiology is large vessel occlusion. Other reported significant neurological complications are GBS/variants, encephalitis, seizures and acute hemorrhagic necrotizing encephalopathy. The reports of ADEM and transverse myelitis lacked diagnostically conclusive data.

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Guillain-Barré syndrome following COVID-19: new infection, old complication?

Cited by 193 publications

References 10 publications

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

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

Neurological Complications of COVID-19: A Systematic Review of Literature

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