Guillain-Barré Syndrome in the COVID-19 Pandemic

Abstract

There have been several reported cases of severe acute respiratory syndrome (SARS-CoV-2) infection that were associated with an increased incidence of neurological manifestations, including Guillain–Barré syndrome (GBS). This review aims to present information on the reports of GBS associated with coronavirus disease 2019 (COVID-19) infection. Our review is retrospective work examining articles published from the 1 April 2020 to the 8 May 2021 in the English language. We used the diagnostic criteria and classification published by the National Institute of Neurological Disorders and Stroke and Brighton Collaboration. GBS is usually a postinfectious syndrome, but GBS in the COVID-19 pandemic also takes on a para-infectious profile. In the reports, the genetic factor has a role in developing GBS in some patients. In conclusion, the association between COVID-19 and GBS is not very clear. Still, one mechanism is strongly associated with COVID-19 and immune-mediated neurological complications, which is molecular mimicry between SARS-CoV-2 and human autoantigens.

Neurographic Evidence of Inflammatory Polyneuropathies in Peri-COVID-19 Circumstances and Their Relationship With Acute Disease Severity and Inflammatory Storm

“…Based on the diagnostic criteria of neuropathy that were mentioned in Table 1 previously and the normal references mentioned in Table 2 , it was found that among the COVID-19 group, GBS was the most common type of inflammatory polyneuropathy, and all the cases were acute inflammatory demyelinating polyneuropathy (AIDP) except one, which was reported as acute motor-sensory axonal neuropathy (AMSAN), and the majority of patients had mixed motor and sensory involvement (Table 5 ). These results are also consistent with those of Tawakul et al in 2022; they found that AIDP was the most common type, and classic sensorimotor GBS was the commonest type and accounted for 56.19% of all cases, while pure motor GBS accounted for 17.14% of patients [ 24 ].…”

“…Also, our findings are similar to those of Zuberbühler et al, who reported in 2021 that male cases accounted for 64.6% of all cases, with a mean age of 56.4 years [ 23 ]. Similarly, according to the most recent published literature by Tawakul et al in 2022, the average age of the patients was 56.6 years, the most common gender was male (59.05% of cases), and only 18.10% of patients had no previous medical history [ 24 ].…”

“…This pattern is comparable to that reported by Tawakul et al in 2022; they claimed that the average period between the onset of COVID-19 symptoms and the onset of GBS signs was 15.77 days. However, post-infectious patterns were observed in 58.10% of people [ 24 ]. Nevertheless, this differs from the findings of Caress et al in 2020, who found that many patients had GBS within seven days of being infected with COVID-19, while the remaining majority acquired GBS between seven and 28 days after the onset of COVID-19 illness [ 11 ].…”

“…Again, these findings have some similarities with other studies that reported the neurological symptoms in COVID-19 patients with GBS were limb weakness (76.19%), paraesthesia or pain (49.52%), and gait impairment (25.71%). Patients with bulbar symptoms accounted for 18.10% of all patients, and hyporeflexia was found in 88% of cases [ 24 ], and Uncini et al discovered that the most clinically significant symptoms are limb weakness (76.2%), hyporeflexia (80.9%), and sensory disturbances (66.7%) [ 21 ].…”

“…Most of these cases (61.1%) did not require hospital admission at the time of acute infection, as the oxygen saturation in 72.2% of patients did not decline below 94%, and regarding the inflammatory biomarkers, they were found to be mildly elevated in all cases, despite these elevations not being too high compared with the average normal reference (Table 8 ). Tawakul et al reported that serum abnormalities were noticed in 41.90% of the patients [ 24 ].…”