Guillain‐Barré syndrome after COVID‐19 vaccines: A Tunisian case series

Abstract

As the COVID‐19 vaccination campaign progresses worldwide, Guillain–Barré syndrome (GBS) vaccine‐related cases have been reported. We carried out a retrospective, descriptive study of GBS patients following COVID‐19 vaccine, submitted to the National Pharmacovigilance Center of Tunis during the period between March 2021 and May 2022. Our study aimed to identify epidemiological and clinical features of COVID‐19 vaccine‐associated GBS. We found 9 cases of GBS post COVID‐19 vaccination; 5 of them were excluded due to the lack of information, whereas 4 cases were included in this study. Men represented 75% (3/4) of the cases. The most frequently reported vaccine type was ChAdOx1 nCoV‐19 vaccine (n = 2 reports [50%]), Ad26.COV2.S vaccine and BNT162b2 vaccine in 1. The mean time interval from vaccination to symptom onset was 15.3 days. Clinical manifestations were different: classical GBS in two cases and GBS with unilateral facial palsy in the other 2 cases. All patients were treated with a course of intravenous immunoglobulin for 5 days. Three patients reported clinical improvement while one case (25%) showed treatment‐related fluctuations. Our observations suggest that COVID‐19 vaccines may be associated with GBS. Continuous surveillance and further studies are warranted to assess the significance of the association.

Post‐COVID vaccination Guillain–Barre syndrome

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We read with interest the article by Berrim et al about four patients with Guillain-Barré syndrome (GBS) after a SARS-CoV-2 vaccination. 1 All four patients had developed acute demyelinating polyneuropathy (AIDP) 7-30 days after vaccination. 1 All four benefited significantly from the administration of intravenous immunoglobulins (IVIG).

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“…1 All four benefited significantly from the administration of intravenous immunoglobulins (IVIG). 1 The study is appealing but raises concerns that warrant further discussion.A limitation of the study is that SARS-CoV-2 infection was not ruled out in each patient. 1 There is no mention that the polymerase chain reaction (PCR) test for SARS-CoV-2 was negative in patient…”

“…1 The study is appealing but raises concerns that warrant further discussion.A limitation of the study is that SARS-CoV-2 infection was not ruled out in each patient. 1 There is no mention that the polymerase chain reaction (PCR) test for SARS-CoV-2 was negative in patient…”

“…1 All four benefited significantly from the administration of intravenous immunoglobulins (IVIG). 1 The study is appealing but raises concerns that warrant further discussion.…”

“…2 We disagree with the notion that autonomic involvement in GBS manifests only as bladder dysfunction. 1 Autonomic involvement in GBS can also manifest as photophobia, drooling, sicca syndrome, postural, orthostatic tachycardia syndrome (POTS), palpitations, gastroparesis, vomiting, diarrhoea, constipation, erectile dysfunction, reduced lubrication, urinary hesitancy, incontinence or hyperhidrosis.…”