COVID-19-Associated Guillain-Barre Syndrome: Atypical Para-infectious Profile, Symptom Overlap, and Increased Risk of Severe Neurological Complications.

Journal: SN comprehensive clinical medicine

Volume: 2

Issue: 12

Year of Publication: 

Affiliated Institutions:  Department of Mental Health and Community Psychology, School of Psychology, Makerere University, P. O. Box, Kampala, Uganda. Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Duke University Medical Center, Box , Durham, NC USA. Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box , Kampala, Uganda.

Abstract summary 

The concurrence of COVID-19 with Guillain-Barre syndrome (GBS) can increase the likelihood of neuromuscular respiratory failure, autonomic dysfunction, and other life-threatening symptoms. Currently, very little is known about the underlying mechanisms, clinical course, and prognostic implications of comorbid COVID-19 in patients with GBS. We reviewed COVID-19-associated GBS case reports published since the outbreak of the pandemic, with a database search up to August 2020, including a manual search of the reference lists for additional relevant cases. Fifty-one (51) case reports of COVID-19 patients (aged 23-84 years) diagnosed with GBS in 11 different countries were included in this review. The results revealed atypical manifestations of GBS, including para-infectious profiles and onset of GBS without antecedent COVID-19 symptoms. Although all tested patients had signs of neuroinflammation, none had SARS-CoV-2 in the cerebrospinal fluid (CSF), and only four (4) patients had antiganglioside antibodies. The majority had a 1- to 10-day time interval between the onset of COVID-19 and GBS symptoms, and many had a poor outcome, with 20 out of the 51 (39.2%) requiring mechanical ventilation, and two deaths within 12 to 24 h. The atypical manifestations of COVID-19-associated GBS, especially the para-infectious profile and short time interval between the onset of the COVID-19 and GBS symptoms, increase the likelihood of symptom overlap, which can complicate the treatment and result in worsened disease progression and/or higher mortality rates. Inclusion of a neurological assessment during diagnosis of COVID-19 might facilitate timely identification and effective management of the GBS symptoms and improve treatment outcome.

Authors & Co-authors:  Kajumba Mayanja M MM Kolls Brad J BJ Koltai Deborah C DC Kaddumukasa Mark M Kaddumukasa Martin M Laskowitz Daniel T DT

Study Outcome 

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Statistics
Citations :  Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020;92:552–555. doi: 10.1002/jmv.25728.
Authors :  6
Identifiers
Doi : 10.1007/s42399-020-00646-w
SSN : 2523-8973
Study Population
Male,Female
Mesh Terms
Other Terms
Atypical;COVID-19;Guillain-Barre;Para-infectious;Prognosis;SARS-CoV-2
Study Design
Case Study,Cross Sectional Study
Study Approach
Country of Study
Publication Country
Switzerland