Guillain-Barre syndrome during COVID-19 pandemic: an overview of the reports
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REVIEW ARTICLE
Guillain-Barre syndrome during COVID-19 pandemic: an overview of the reports Kaveh Rahimi 1 Received: 29 June 2020 / Accepted: 28 August 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Similar to severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), the coronavirus disease 2019 (COVID-19) has neurological symptoms. COVID-19 patients have such clinical symptoms as headache, vomiting, nausea, dizziness, myalgia, anosmia, ageusia, and disorder of consciousness. These symptoms confirm that the nervous system is involved in the COVID-19 infection. Guillain-Barré syndrome (GBS) is a heterogeneous disorder which often follows a viral infection. According to the assessment case reports from the beginning of the COVID-19 infection so far, it is possible that GBS is linked to the COVID-19 infection. It seems that paying attention to the neurological effects of COVID-19 is necessary. Keywords Guillain-Barré syndrome . SARS . MERS . COVID-19
Introduction The first unexplained pneumonia cases occurred in Wuhan, China, and quickly spread to other countries [1]. It was later revealed that these unexplained pneumonia cases had been caused by a new coronavirus. It has been stated that the symptoms of this new coronavirus infection are very similar to those of SARS-CoV which spread in 2003 [2]. Both act on the same receptor, namely the angiotensin-converting enzyme 2. This virus is called SARS-CoV-2 and has been called by the WHO as the coronavirus disease 2019 (COVID-19) [3, 4]. COVID-19, like SARS-CoV and MERS-CoV, affects the nervous system. The neurological manifestations of the COVID-19 infection are due to its effects on the central nervous system (CNS) (headache, dizziness, consciousness disorder, acute brain disease, seizures, and ataxia), [5] peripheral nervous system (PNS) (anosmia, ageusia, visual impairment, nerve pain), and skeletal muscles [6]. Guillain-Barré syndrome (GBS) is an autoimmune disorder related to the peripheral nervous system. The clinical characteristics of GBS are the progressive weakness of the limbs and
* Kaveh Rahimi [email protected] 1
Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
reduction in or loss of tendon reflexes (hyporeflexia and areflexia, respectively). In this disorder, protein concentrations in the cerebrospinal fluid (CSF) increase, while the white cell count is normal [7, 8]. GBS is usually caused by a viral or bacterial infection. In response to the antigen, the immune system is activated and the nerve roots and peripheral nerves are injured because of the structural similarity of this antigen to axons and myelin [9]. The symptoms peak within 4 weeks and the patients should be monitored because 20% to 30% of them will need mechanical ventilation [10, 11]. The goal of the current study was to review the available information on the reports of GBS associated with the COVID-19 infection.
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