Post-Infectious Guillain–Barré Syndrome Related to SARS-CoV-2 Infection: A Systematic Review

Sansone, Pasquale; Giaccari, Luca Gregorio; Aurilio, Caterina; Coppolino, Francesco; Esposito, V.; Fiore, Marco; Paladini, Antonella; Passavanti, Maria Beatrice; Pota, Vincenzo; Pace, Maria Caterina

doi:10.3390/life11020167

Cited by 32 publications

(36 citation statements)

References 55 publications

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“…In contrast to the presence of peculiarities of our cases, in a recent epidemiological and cohort study recorded by Keddie et al (33), they compared COVID-19 (definite or probable)and non-COVID-19-associated GBS patients and found no significant differences in the pattern of weakness, time to nadir, neurophysiology, or outcome. Two other systematic reviews by Abu-Rumeileh et al (11) and Sansone et al (34) showed that the clinical picture of COVID-19-associated GBS seems to resemble that of classic GBS or Zika virus-associated GBS.…”

Section: Discussionmentioning

confidence: 97%

Case Report: Guillain–Barré Syndrome Associated With COVID-19

et al. 2021

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Guillain–Barré syndrome (GBS) is a potentially fatal, immune-mediated disease of the peripheral nervous system that is usually triggered by infection. Only a small number of cases of GBS associated with COVID-19 infection have been published. We report here five patients with GBS admitted to the Neurology, Psychiatry, and Neurosurgery Hospital, Assiut University/Egypt from July 1 to November 20, 2020. Three of the five patients were positive for SARS-CoV-2 following polymerase chain reaction (PCR) of nasopharyngeal swabs on day of admission and another one had a high level of IgM and IgG; all had bilateral ground-glass opacities with consolidation on CT chest scan (GGO) and lymphopenia. All patients presented with two or more of the following: fever, cough, malaise, vomiting, and diarrhea with variable duration. However, there were some peculiarities in the clinical presentation. First, there were only 3 to 14 days between the onset of COVID-19 symptoms and the first symptoms of GBS, which developed into flaccid areflexic quadriplegia with glove and stocking hypoesthesia. The second peculiarity was that three of the cases had cranial nerve involvement, suggesting that there may be a high incidence of cranial involvement in SARS-CoV-2-associated GBS. Other peculiarities occurred. Case 2 presented with a cerebellar hemorrhage before symptoms of COVID-19 and had a cardiac attack with elevated cardiac enzymes following onset of GBS symptoms. Case 5 was also unusual in that the onset began with bilateral facial palsy, which preceded the sensory and motor manifestations of GBS (descending course). Neurophysiological studies showed evidence of sensorimotor demyelinating polyradiculoneuropathy, suggesting acute inflammatory polyneuropathy (AIDP) in all patients. Three patients received plasmapheresis. All of them had either full recovery or partial recovery. Possible pathophysiological links between GBS and COVID-19 are discussed.

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Section: Discussionmentioning

confidence: 97%

Case Report: Guillain–Barré Syndrome Associated With COVID-19

et al. 2021

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“…Nevertheless, the rapid development of the pandemic may have significantly influenced the general attitude towards vaccination. In the meantime, it is known that COVID‐19 infection may trigger GBS 37,38 . Also in addition, different kinds of COVID‐19 vaccines have been reported to have the potential to trigger GBS 39‐42 …”

Section: Discussionmentioning

confidence: 99%

Patients' attitude towards vaccination after Guillain Barré syndrome

Holtz

Grimm²,

Axer

2021

Health Science Reports

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Background and Aims Guillain Barré syndrome (GBS) could be triggered by an infectious disease but by vaccination as well. Thus, suffering GBS may influence patients' attitudes towards vaccination. Methods An anonymous questionnaire consisting of the Overall Neuropathy Limitations Score (ONLS), the short form‐36 health survey (SF‐36), and questions addressing patients' attitude towards vaccination was sent to members of a German GBS support group and to patients with GBS diagnosis who were treated at Jena University Hospital. Results Ninety‐seven questionnaires clearly stated GBS as a diagnosis and were included in the analysis. Although 19.6% of the GBS patients reported having no disability in the long‐time follow‐up, a considerable number of patients still had persistent neurological symptoms; 74.2% of the GBS patients reported being able to walk at least 10 m independently. However, 5.2% were restricted to wheelchair. The patients reached lower scores in all domains of quality of life compared to German controls. Moreover, patients showed a more critical attitude towards vaccination compared to a German representative survey. Fewer patients (58.8%) received a vaccination after suffering from GBS than before (77.3%). Every tenth patient believed that vaccination was the trigger for the GBS. 32% of the patients did not receive a vaccination in the last 5 years mainly because of the fear of adverse effects (32%) or disadvise of the general practitioners (25.8%). Discussion Although the risk of relapse following immunization may be rather low, uncertainties and fears still impair the counseling of these patients by their medical practitioner.

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“…MRI can reveal thickening of the affected nerve roots and avid contrast enhancement of the conus medullaris and cauda equina, with preferential enhancement of the ventral nerve roots[ 141 ]. The fact that viral RNA has not been identified on cerebrospinal fluid analysis in affected patients suggests that injury occurs via an immune-mediated mechanism, such as molecular mimicry or antibody precipitation, rather than by direct viral insult[ 142 ]. A similar mechanism has been proposed for rare cases of new-onset myasthenia gravis developing in the setting of COVID-19[ 143 ].…”

Section: Extrapulmonary Manifestationsmentioning

confidence: 99%

Imaging in the COVID-19 era: Lessons learned during a pandemic

Sidéris

Nikolakea²,

Karanikola³

et al. 2021

WJR

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The first year of the coronavirus disease 2019 (COVID-19) pandemic has been a year of unprecedented changes, scientific breakthroughs, and controversies. The radiology community has not been spared from the challenges imposed on global healthcare systems. Radiology has played a crucial part in tackling this pandemic, either by demonstrating the manifestations of the virus and guiding patient management, or by safely handling the patients and mitigating transmission within the hospital. Major modifications involving all aspects of daily radiology practice have occurred as a result of the pandemic, including workflow alterations, volume reductions, and strict infection control strategies. Despite the ongoing challenges, considerable knowledge has been gained that will guide future innovations. The aim of this review is to provide the latest evidence on the role of imaging in the diagnosis of the multifaceted manifestations of COVID-19, and to discuss the implications of the pandemic on radiology departments globally, including infection control strategies and delays in cancer screening. Lastly, the promising contribution of artificial intelligence in the COVID-19 pandemic is explored.

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Post-Infectious Guillain–Barré Syndrome Related to SARS-CoV-2 Infection: A Systematic Review

Cited by 32 publications

References 55 publications

Case Report: Guillain–Barré Syndrome Associated With COVID-19

Case Report: Guillain–Barré Syndrome Associated With COVID-19

Patients' attitude towards vaccination after Guillain Barré syndrome

Imaging in the COVID-19 era: Lessons learned during a pandemic

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