Occurrence of Guillain-Barre Syndrome During the Initial Symptomatic Phase of COVID-19 Disease: Coincidence or Consequence?

Seixas, Rui; Campoamor, David; Lopes, João; Bernardo, Teresa; Nzwalo, Hipólito; Pascoalinho, Dulce

doi:10.7759/cureus.19655

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…It has been shown that antibodies to SARS-CoV-2 can cross-react with peripheral myelin causing GBS ( 39 ). GBS usually manifests with a florid picture of clinical dysautonomia that includes the presence of hemodynamic instability, urinary retention, gastroplegia, paralytic ileus or refractory hypertension ( 40 ).…”

Section: The Role Of Dysautonomia In the Clinical Course Of Covid-19mentioning

confidence: 99%

Dysautonomia in COVID-19 Patients: A Narrative Review on Clinical Course, Diagnostic and Therapeutic Strategies

et al. 2022

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IntroductionOn March 11, 2020, the World Health Organization sounded the COVID-19 pandemic alarm. While efforts in the first few months focused on reducing the mortality of infected patients, there is increasing data on the effects of long-term infection (Post-COVID-19 condition). Among the different symptoms described after acute infection, those derived from autonomic dysfunction are especially frequent and limiting.ObjectiveTo conduct a narrative review synthesizing current evidence of the signs and symptoms of dysautonomia in patients diagnosed with COVID-19, together with a compilation of available treatment guidelines.ResultsAutonomic dysfunction associated with SARS-CoV-2 infection occurs at different temporal stages. Some of the proposed pathophysiological mechanisms include direct tissue damage, immune dysregulation, hormonal disturbances, elevated cytokine levels, and persistent low-grade infection. Acute autonomic dysfunction has a direct impact on the mortality risk, given its repercussions on the respiratory, cardiovascular, and neurological systems. Iatrogenic autonomic dysfunction is a side effect caused by the drugs used and/or admission to the intensive care unit. Finally, late dysautonomia occurs in 2.5% of patients with Post-COVID-19 condition. While orthostatic hypotension and neurally-mediated syncope should be considered, postural orthostatic tachycardia syndrome (POTS) appears to be the most common autonomic phenotype among these patients. A review of diagnostic and treatment guidelines focused on each type of dysautonomic condition was done.ConclusionSymptoms deriving from autonomic dysfunction involvement are common in those affected by COVID-19. These symptoms have a great impact on the quality of life both in the short and medium to long term. A better understanding of the pathophysiological mechanisms of Post-COVID manifestations that affect the autonomic nervous system, and targeted therapeutic management could help reduce the sequelae of COVID-19, especially if we act in the earliest phases of the disease.

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Section: The Role Of Dysautonomia In the Clinical Course Of Covid-19mentioning

confidence: 99%

Dysautonomia in COVID-19 Patients: A Narrative Review on Clinical Course, Diagnostic and Therapeutic Strategies

et al. 2022

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“…A recent study of 5 million patients revealed that COVID-19 survivors experienced a significant increase (up to 2,000%) in the risk of suffering from cardiovascular (infarction, arrhythmias), pulmonary (hypoxemia, dyspnea), metabolic (diabetes, dyslipidemia) and neurological (cognitive impairment, sleep disorders, cerebral infarction) conditions from 1 to 6 months post-infection ( 1 ), with the highest risk observed in patients who were critical, followed by hospitalized and asymptomatic patients ( 3 ). Subsequent studies have shown a relationship between cardiovascular sequelae of COVID-19 and development of dysautonomia ( 6 ), often a product of chronic systemic inflammation that increases sympathetic nerve activity ( 6 – 8 ). This dysautonomia is a component of “post-COVID Guillan-Barré syndrome” (PCGBS) which is the most recurrent type of neurological post-COVID disorder (observed in 15% of patients) ( 8 – 11 ) and has been linked to the neuro-psychological sequelae of long COVID, such as anxiety, depression, and cognitive impairment ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular and autonomic dysfunction in long-COVID syndrome and the potential role of non-invasive therapeutic strategies on cardiovascular outcomes

et al. 2023

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A significant percentage of COVID-19 survivors develop long-lasting cardiovascular sequelae linked to autonomic nervous system dysfunction, including fatigue, arrhythmias, and hypertension. This post-COVID-19 cardiovascular syndrome is one facet of “long-COVID,” generally defined as long-term health problems persisting/appearing after the typical recovery period of COVID-19. Despite the fact that this syndrome is not fully understood, it is urgent to develop strategies for diagnosing/managing long-COVID due to the immense potential for future disease burden. New diagnostic/therapeutic tools should provide health personnel with the ability to manage the consequences of long-COVID and preserve/improve patient quality of life. It has been shown that cardiovascular rehabilitation programs (CRPs) stimulate the parasympathetic nervous system, improve cardiorespiratory fitness (CRF), and reduce cardiovascular risk factors, hospitalization rates, and cognitive impairment in patients suffering from cardiovascular diseases. Given their efficacy in improving patient outcomes, CRPs may have salutary potential for the treatment of cardiovascular sequelae of long-COVID. Indeed, there are several public and private initiatives testing the potential of CRPs in treating fatigue and dysautonomia in long-COVID subjects. The application of these established rehabilitation techniques to COVID-19 cardiovascular syndrome represents a promising approach to improving functional capacity and quality of life. In this brief review, we will focus on the long-lasting cardiovascular and autonomic sequelae occurring after COVID-19 infection, as well as exploring the potential of classic and novel CRPs for managing COVID-19 cardiovascular syndrome. Finally, we expect this review will encourage health care professionals and private/public health organizations to evaluate/implement non-invasive techniques for the management of COVID-19 cardiovascular sequalae.

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Occurrence of Guillain-Barre Syndrome During the Initial Symptomatic Phase of COVID-19 Disease: Coincidence or Consequence?

Cited by 2 publications

References 9 publications

Dysautonomia in COVID-19 Patients: A Narrative Review on Clinical Course, Diagnostic and Therapeutic Strategies

Dysautonomia in COVID-19 Patients: A Narrative Review on Clinical Course, Diagnostic and Therapeutic Strategies

Cardiovascular and autonomic dysfunction in long-COVID syndrome and the potential role of non-invasive therapeutic strategies on cardiovascular outcomes

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