Guillain-Barre syndrome associated to COVID-19 infection: a review of published case reports
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P Zuberbühler1, M E Conti2, L León-Cejas3
1Hospital General de Agudos Dr. Teodoro Álvarez, Ciudad Autónoma de Buenos Aires, Argentina.
Insights
COVID-19 is linked to Guillain-Barré syndrome (GBS) and its variants. This review of 48 patients shows GBS often presents with neurological symptoms within 12 days of COVID-19, with most cases responding to treatment.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- The COVID-19 pandemic has emerged as a significant global health crisis.
- Neurological complications, including Guillain-Barré syndrome (GBS), are increasingly recognized in patients with COVID-19.
- Understanding the relationship between SARS-CoV-2 infection and GBS is crucial for patient management and prognosis.
Purpose of the Study:
- To review and analyze clinical cases of GBS associated with COVID-19 infection.
- To characterize the clinical presentation, electrophysiological findings, and outcomes of GBS in COVID-19 patients.
- To explore potential associations between specific COVID-19 symptoms and GBS characteristics.
Main Methods:
- A review of clinical cases of GBS associated with COVID-19 infection was conducted.
- Data from 48 patients were analyzed, including demographics, COVID-19 symptoms, neurological manifestations, electrodiagnostic patterns, treatments, and outcomes.
- Statistical associations between COVID-19 symptoms (e.g., hyposmia/dysgeusia) and GBS characteristics were examined.
Main Results:
- The study included 48 patients (31 men, mean age 56.4 years) with GBS and COVID-19.
- Common COVID-19 symptoms were cough (60.4%) and fever (56.3%). Neurologic manifestations appeared a mean of 12.1 days after COVID-19 symptoms.
- The classic sensory motor variant of GBS was most common (75%), with demyelinating patterns on electrophysiology (82.4%). Hyposmia/dysgeusia was linked to shorter latency and cranial nerve involvement.
- Most patients (87.5%) received intravenous immunoglobulin, with favorable neurological outcomes in 64.6%.
Conclusions:
- GBS in COVID-19 patients shares clinical and electrophysiological similarities with classical GBS forms.
- Further research is needed to confirm if SARS-CoV-2 infection increases GBS frequency and to elucidate pathogenic mechanisms.
- Early recognition and treatment of GBS in the context of COVID-19 are essential for improving patient outcomes.
Introduction:
The coronavirus disease 2019 (COVID-19) pandemic is a major worldwide health disorder. There is an increasing number of neurological complications recognized with COVID-19 including patients with GBS and its variants.
Development:
A review of the clinical cases of GBS associated to COVID-19 infection published in the last months has been developed. We included 48 patients (31 men, mean age 56.4 years). The most common COVID-19 symptoms were cough (60.4%) and fever (56.3%). Mean time from COVID-19 symptoms to neurologic manifestations was 12.1 days, but in nine patients (18.8%) developed GBS within seven days. Eleven patients (22.9%) presented cranial nerve involvement in the absence of muscle weakness; 36 presented the classic sensory motor variant (75%) and one had a pure motor variant (2.1%). The electrodiagnostic pattern was considered demyelinating in 82.4% of the generalized variants. The presence of hyposmia/dysgeusia was associated with a latency shorter than seven days to GBS onset of symptoms (30% vs 15.6%), and cranial nerve involvement in the absence of weakness (30.8% vs 17.1%). Most patients (87.5%) were treated with intravenous immunoglobulin. Neurological outcome was favorable in 64.6%; 29.2% had respiratory failure and 4.2% died shortly after being admitted.
Conclusions:
GBS in patients with SARS-CoV-2 infection resembles clinically and electrophysiology the classical forms. Further studies are necessary to understand whether GBS frequency is actually increased due to SARS-CoV-2 infection and explore pathogenic mechanisms.
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