Guillain-Barre Syndrome Followed by Covid-19 Infection, Vaccination and Other Precipitating Factors during the Pandemic

Abstract

Background and Aims: Guillain-Barré syndrome (GBS) is usually triggered by an infection. Vaccination is mentioned as a possible trigger in a small number of GBS cases. The aim of this study was to notice GBS distinctness provoked by various triggers during the COVID-19 pandemic. Material and Methods: A total of 109 GBS patients were divided into three groups, respectively: COVID-19 infection associated (19 patients), COVID-19 vaccination associated (16 patients) and precipitated by some other factors (74 patients). We compared the clinical, neurophysiological and laboratory characteristics of these three groups. Results: Neither were differences recorded in the age of the patients of these three groups at the time of illness, nor in the number of days from the precipitating factor to the onset of symptoms. There were no clinical differences between groups related to severity of the disease or patients’ recovery. The only clinical difference was observed in relation to facial nerve bilateral affection because it was significantly higher in the post-vaccination group. According to neurophysiological findings, demyelinating form dominated in all three groups. Conclusion: Clinical characteristics, electrophysiological findings and laboratory characteristics did not differ significantly in Guillain-Barre syndrome followed by COVID-19 infection, vaccination and other precipitating factors during the pandemic. The bilateral involvement of facial nerves was significantly higher in the post-vaccination group. Most of these cases had a mild form of the disorder—distal paresthesias GBS variant.

The Neurological Implications of COVID-19: A Comprehensive Narrative Review

“…As seen in multiple other studies and articles, the best therapeutic for GBS related to COVID-19 is the standard IVIg therapy and plasma exchange treatment. The difference between regular treatment before and after being affected by COVID-19 was not drastic, and patients should continue to follow the standard therapeutics of any GBS patient [ 134 ]. GBS, being an inflammatory polyradiculoneuropathy, is associated with numerous viral infections.…”

COVID-19, Vaccine, and Guillain–Barré Syndrome: Association or Causation

“…have presented an original study on the GBS followed by coronavirus disease 2019 (COVID-19) infection, vaccination, and other precipitating factors during the pandemic in Serbia and Montenegro. [ 2 ] They retrospectively recruited 109 GBS patients between January and April 2022 into the following three groups: COVID-19 infection-associated (19 cases), COVID-19 vaccination-associated (16 cases), and other causes (74 cases). Individuals positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on polymerase chain reaction (PCR) testing were classified as COVID-19-positive.…”

“…The authors reported 16 cases of COVID-19 vaccine-induced GBS in the background of 54.1% coverage in adults in a population of 7,806,891 people. [ 2 ] The first dose of vaccines was the most common dose implicated, with Sinopharm use associated with most cases. AstraZeneca and Covaxin were the vaccines most commonly used in India, and very few vaccine-associated GBS cases have been reported.…”

“…They reported a higher likelihood of cranial nerve involvement in such GBS cases, similar to Martic, et al . [ 2 ] It should be added that this GBS occurrence post-vaccination does not necessarily prove causation. Temporal associations do not imply causality.…”