Guillain-Barré Syndrome (GBS) as a COVID-19 Complication: A Multicenter Study Conducted Throughout the 2-Year Pandemic

Several studies have been published on the coexistence of Guillain-Barré syndrome (GBS) and COVID-19, raising the question of whether SARS-CoV-2 plays a role in GBS pathogenesis or is just a coincidence. In this research, we discuss GBS characteristics in COVID-19 patients during the pandemic.

This cross-sectional, multi-center study was performed on patients who were hospitalized in one of two GBS referral hospitals in Isfahan Providence between March 2020 to March 2022. All confirmed GBS and COVID-19 patients with no other known risk factor for GBS and no more than 28 days of COVID-19 treatment were entered into the trial.

Totally, 45 patients were collected. The most prevalent EDX pattern was AIDP (57.8%). As compared to demyelinating injuries, axonal injuries were significantly more associated with lung involvement (P value: 0.022), higher GBS disability score (P value: 0.034), poorer response to treatment (P value: 0.021), higher serum inflammatory level, and older onset (P value: 0.013). The average period between the onset of COVID-19 and the onset of GBS symptoms was 18.07 ± 9.88 days. 46.3% of patients developed GBS within the first two weeks of COVID-19, a condition known as a para-infection. The axonal injury was significantly more prevalent in these individuals (P value: 0.045).

An earlier onset of neurological symptoms and para-infection conditions is associated with an increase in the frequency of axonal-type variations and, as a result, a poor prognosis. The majority of evidence in COVID-19-related GBS patients points to an autoimmune process.