Late onset of Guillain-Barré syndrome following SARS-CoV-2 infection: part of ‘long COVID-19 syndrome’?

Raahimi, Mina M; Kane, Alice E.; Moore, Christopher; Alareed, Ahmad W

doi:10.1136/bcr-2020-240178

Cited by 55 publications

(44 citation statements)

References 21 publications

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“…One case was excluded as it met one of the exclusion criteria; the latency between the onset of COVID-19 infection and the GBS onset of symptoms was 53 d (>6 weeks). 93 The applied investigations in confirming COVID-19 infection at the time of arboviral symptoms were COVID-19 PCR testing, detection of SARS-CoV2 antibodies, and suggestive features on chest radiography. Cases with either positive PCR or SARS-CoV2 antibodies were categorized as confirmed cases, whereas patients diagnosed based on abnormal chest radiographs or clinical suspicion only were categorized as suspected cases.…”

Section: Resultsmentioning

confidence: 99%

Guillain Barre Syndrome as a Complication of COVID-19: A Systematic Review

Aladawi

Elfil

Abu-Esheh

et al. 2021

Can. J. Neurol. Sci.

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Background: In January 2020, the first case of Guillain Barre syndrome (GBS) due to COVID-19 was documented in China. GBS is known to be postinfectious following several types of infections. Although causality can only be proven through large epidemiological studies, we intended to study this association by a thorough review of the literature. Methods: We searched PubMed, EMBASE, and Google scholar and included all papers with English or Spanish full text and original data of patients with GBS and recent COVID infection. Variables of interest were demographics, diagnostic investigations, and the latency between arboviral and neurological symptoms. Further variables were pooled to identify GBS clinical and electrophysiological variants, used treatments, and outcomes. The certainty of GBS diagnosis was verified using Brighton criteria. Results: We identified a total of 109 GBS cases. Ninety-nine cases had confirmed COVID-19 infection with an average age of 56.07 years. The average latency period between the arboviral symptoms and neurologic manifestations for confirmed COVID-19 cases was 12.2 d. The predominant GBS clinical and electromyography variants were the classical sensorimotor GBS and acute demyelinating polyneuropathy respectively. Forty cases required intensive care, 33 cases required mechanical ventilation, and 6 cases were complicated by death. Conclusions: Studies on COVID-19-related GBS commonly reported sensorimotor demyelinating GBS with frequent facial palsy. The time between the onset of infectious and neurological symptoms suggests a postinfectious mechanism. Early diagnosis of GBS in COVID-19 patients is important as it might be associated with a severe disease course requiring intensive care and mechanical ventilation.

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Section: Resultsmentioning

confidence: 99%

Guillain Barre Syndrome as a Complication of COVID-19: A Systematic Review

Aladawi

Elfil

Abu-Esheh

et al. 2021

Can. J. Neurol. Sci.

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“…At a longer follow-up of 6 months, Pilotto et al, analyzing retrospectively 165 moderate-to-severe COVID-19 patients, showed that these long-term symptoms persisted in about 37% of patients (61). Also, symptoms consistent with orthostatic hypoperfusion syndrome and painful small fiber neuropathy were reported at short (3 weeks) and long (up to 3 months) follow-ups in two case-reports and in a small case-series (48,59,63). In a "Long-Haul COVID" communication, Nath et al, summarizing symptoms reported after mild-to-severe COVID-19, also highlighted persistent symptoms that overlapped with those patients with myalgic encephalomyelitis/chronic fatigue syndrome (117).…”

Section: Persistent Neurological Symptoms and Olfactory Dysfunctionsmentioning

confidence: 99%

Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

et al. 2021

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Whilst the entire world is battling the second wave of COVID-19, a substantial proportion of patients who have suffered from the condition in the past months are reporting symptoms that last for months after recovery, i. e., long-term COVID-19 symptoms. We aimed to assess the current evidence on the long-term symptoms in COVID-19 patients. We did a systematic review on PubMed, Web of Science, EMBASE, and Google Scholar from database inception to February 15, 2021, for studies on long-term COVID-19 symptoms. We included all type of papers that reported at least one long-term COVID-19 symptom. We screened studies using a standardized data collection form and pooled data from published studies. Cohort cross-sectional, case-report, cases-series, case-control studies, and review were graded using specific quality assessment tools. Of 11,361 publications found following our initial search we assessed 218 full-text articles, of which 145 met all selection criteria. We found that 20.70% of reports on long-term COVID-19 symptoms were on abnormal lung functions, 24.13% on neurologic complaints and olfactory dysfunctions, and 55.17% on specific widespread symptoms, mainly chronic fatigue, and pain. Despite the relatively high heterogeneity of the reviewed studies, our findings highlighted that a noteworthy proportion of patients who have suffered from SARS-CoV-2 infection present a “post-COVID syndrome.” The multifaceted understanding of all aspects of the COVID-19 pandemic, including these long-term symptoms, will allow us to respond to all the global health challenges, thus paving the way to a stronger public health.

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“…Furthermore, our patient presented with an AMSAN, whereas the majority of reported cases present with a demyelinating polyradiculoneuropathy [ 1 , 6 , 7 ]. A previous case report details late onset GBS 53 days following SARS-CoV-2 infection [ 8 ]. Our patient demonstrated a distinctly longer latency period between COVID-19 symptoms and GBS than previously reported cases.…”

Section: Discussionmentioning

confidence: 99%