Guillain–Barré Syndrome as a Neurological Complication of COVID-19 Infection: A Case Series and Review of the Literature

Mozhdehipanah, Hossein; Paybast, Sepideh; Gorji, Reza

doi:10.34172/icnj.2020.18

Cited by 25 publications

(29 citation statements)

References 11 publications

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“…1 ). The mean age at onset was 55 ± 17 years (min 11–max 94), including four pediatric cases [ 21 , 27 , 35 , 41 ]. A significative prevalence of men compared to women was noticed (50 vs. 23 cases: 68.5% vs. 31.5%) with no significant difference in age at onset between men and women (mean: 55 ± 18 vs. 56 ± 16 years, p = 0.643).…”

Section: Resultsmentioning

confidence: 99%

“…All cases with available therapy data ( n = 70) except ten [ 13 , 15 , 23 , 25 , 26 , 33 , 35 – 37 , 41 ] were treated with intravenous immunoglobulin (IVIG) (Table 1 ). Conversely, plasma exchange and steroid therapy were performed in ten (four of them received also IVIG) and two cases, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…In the present study, mean age at onset in patients with GBS largely overlapped that of classic COVID-19 subjects [ 70 , 71 ]. However, pediatric cases with GBS have been increasingly reported in the literature [ 21 , 27 , 35 , 41 ], suggesting that, with the spreading of the pandemic, a broader age range might be affected. Moreover, we found a higher prevalence of GBS in males compared to females, as previously reported for Zika virus–GBS [ 72 ].…”

Section: Discussionmentioning

confidence: 99%

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Guillain–Barré syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases

et al. 2020

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Since coronavirus disease-2019 (COVID-19) outbreak in January 2020, several pieces of evidence suggested an association between the spectrum of Guillain-Barré syndrome (GBS) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Most findings were reported in the form of case reports or case series, whereas a comprehensive overview is still lacking. We conducted a systematic review and searched for all published cases until July 20th 2020. We included 73 patients reported in 52 publications. A broad age range was affected (mean 55, min 11-max 94 years) with male predominance (68.5%). Most patients showed respiratory and/or systemic symptoms, and developed GBS manifestations after COVID-19. However, asymptomatic cases for COVID-19 were also described. The distributions of clinical variants and electrophysiological subtypes resemble those of classic GBS, with a higher prevalence of the classic sensorimotor form and the acute inflammatory demyelinating polyneuropathy, although rare variants like Miller Fisher syndrome were also reported. Cerebrospinal fluid (CSF) albuminocytological dissociation was present in around 71% cases, and CSF SARS-CoV-2 RNA was absent in all tested cases. More than 70% of patients showed a good prognosis, mostly after treatment with intravenous immunoglobulin. Patients with less favorable outcome were associated with a significantly older age in accordance with previous findings regarding both classic GBS and COVID-19. COVID-19-associated GBS seems to share most features of classic post-infectious GBS and possibly the same immune-mediated pathogenetic mechanisms. Nevertheless, more extensive epidemiological studies are needed to clarify these issues.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Guillain–Barré syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases

et al. 2020

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“…The total number of participants in the included studies was 83 in which 60 were male and 23 were female. However, five out of the total number of participants were children ( 56 – 58 , 62 , 68 ). Consequently, the age range of the patients was between 11 and 94 years.…”

Section: Resultsmentioning

confidence: 99%

Is Guillain–Barré Syndrome Associated With COVID-19 Infection? A Systemic Review of the Evidence

et al. 2021

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Background: There is emerging evidence that Guillain–Barré syndrome (GBS) may be associated with coronavirus disease 2019 (COVID-19) infection. The aim of this review was to investigate the strength of the evidence.Method: The review was registered in PROSPERO (CDR42020184822). Three electronic databases, MEDLINE, PubMed, and Web of Science, and three preprint servers, MedRvix, ChemRvix, and BioRvix, were searched from December 2019 to 24th September 2020. Studies were included if they were on COVID-19 and of any design. Articles that are reviews or opinion were excluded. The selection process was carried out using EndNote and Rayyan software. The main outcomes in the study were study design, sample size, sex, age, overall GBS symptoms, other COVID-19 symptoms, comorbidity, timing between infection and the onset of neurological symptoms, CT, MRI, and EMG results. Methodological quality of the studies was assessed using the McMaster Critical Review Form. The collected data was analyzed using qualitative synthesis.Findings: Fifty-one high-quality studies (mostly) consisting of 83 patients were included in the study. All of the patients (except in a very few) in the included studies had confirmed diagnosis of COVID-19. Similarly, the diagnosis of GBS was based on standard clinical, electrophysiological, and cerebrospinal fluid (CSF) criteria.Conclusion: GBS may be associated with COVID-19, and therefore, testing for COVID-19 is recommended in patients presenting with GBS during this pandemic.

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“…In addition to specific central nervous system (CNS) and peripheral nervous system (PNS) symptoms, nonspecific neurological manifestations such as headache, myalgia, anosmia, hypogeusia, myopathy have been reported in patients with COVID-19 [4] . The spectrum of neurologic complications ranges from CNS involvement like meningitis/encephalitis, encephalopathy, stroke and PNS involvement like Guillian-Barre Syndrome (GBS) [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ]. The severity of the disease varies based on the virus nervous tissue tropism.…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Systematic Review of CSF analysis that defines Neurological Manifestations of COVID-19

Tandon¹,

Kataria²,

Patel³

et al. 2021

International Journal of Infectious Diseases

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Guillain–Barré Syndrome as a Neurological Complication of COVID-19 Infection: A Case Series and Review of the Literature

Cited by 25 publications

References 11 publications

Guillain–Barré syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases

Guillain–Barré syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases

Is Guillain–Barré Syndrome Associated With COVID-19 Infection? A Systemic Review of the Evidence

A Comprehensive Systematic Review of CSF analysis that defines Neurological Manifestations of COVID-19

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