Guillain–Barré syndrome associated with SARS‐CoV‐2 infection. A systematic review

Abstract

Guillain-Barr e syndrome (GBS) incidence can increase during outbreaks of infectious illnesses. A few cases of GBS associated with coronavirus disease 2019 (COVID-19) infection have been reported. The aim was to identify specific clinical features of GBS associated with COVID-19. PubMed, Embase and Cochrane were searched from 1 November 2019 to 17 May 2020 and included all papers with full text in English, Spanish, French or Italian, reporting original data of patients with GBS and COVID-19. Data were extracted according to a predefined protocol. A total of 18 patients reported in 14 papers were included in this review. All the patients were symptomatic for COVID-19, with cough and fever as the most frequently reported symptoms. The interval between the onset of symptoms of COVID-19 and the first symptoms of GBS ranged from À8 to 24 days (mean 9 days; median 10 days). Most of the patients had a typical GBS clinical form predominantly with a demyelinating electrophysiological subtype. Mechanical ventilation was necessary in eight (44%) patients. Two (11%) patients died. Published cases of GBS associated with COVID-19 report a sensorimotor, predominantly demyelinating GBS with a typical clinical presentation. Clinical features and disease course seem similar to those observed in GBS related to other etiologies. These results should be interpreted with caution since only 18 cases have been heterogeneously reported so far.

The JANUS of chronic inflammatory and autoimmune diseases onset during COVID-19 – A systematic review of the literature

“…Thus, it is not surprising to note the increasing number of reports on COVID-19 patients with acute immune-mediated like neurologic signs and symptoms, published in the literature since the beginning of the pandemic. A recent systematic review showed that published cases of GBS induced by SARS-CoV-2 reported mostly a sensorimotor, demyelinating GBS with a typical clinical presentation, which is similar to GBS cases due to other etiological factors [ 82 ]. Table 9 summarizes the case reports/series identified through our research strategy.…”

GM1 ganglioside antibody and COVID-19 related Guillain Barre Syndrome – A case report, systemic review and implication for vaccine development

“…The most recent review paper by Abu-Rumeileh et al is also the most extensive, which included 73 cases [ 3 ]. It included most of the cases reviewed in the other seven review papers that were published prior [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Only two additional cases have been identified by a shorter review paper by Ellul et al [ 7 ].…”

“…Searches were performed cross referencing the following key terms “Covid-19”, “Guillain Barre”, “Miller Fisher”, “GM1”, “GQ1b”, and “Ganglioside”. Of the 102 articles found eight were large scale review papers [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]; the other entries were all case reports. All cases included in the eight review papers and each separate case studies were reviewed.…”

Guillain–Barré syndrome as a parainfectious manifestation of SARS-CoV-2 infection: A case series

“…All reported patients in this study received intravenous immunoglobulin (IVIg) except for two (88.9%); while one underwent plasma exchange after IVIg therapy. [13] . Here, we reported three cases of GBS during the active phase of COVID-19 pandemic.…”