ABSTRACT
Objective: To assess if patients with persistent positive nasopharyngeal polymerase chain reaction (PCR) swab for SARS CoV-2 (COVID-19) virus seem to be at a higher risk of developing complications like acute transverse myelitis (ATM). Background: ATM as post-infectious sequelae was mostly attributed to bacteria-like Mycoplasma pneumonia or viruses like varicella in the pre-pandemic times. However, in the light of the world seeing two waves of the COVID-19, ATM as a post-COVID-19 sequelae is being reported more frequently. Design/Methods: The literature search was done using PubMed and Google scholar using keywords. The search criteria was set to filter cases of ATM in COVID-19 patients, reports between Jan 2020 to July 2021. A total of eight case reports were selected from peer reviewed journals. Results: The reported cases included a total of eight patients ranging from 32-72 years of age. Of the eight case reports, five presented after two weeks of initial COVID-19 symptoms. Seven of the eight patients tested positive for a nasopharyngeal PCR swab for COVID-19 at the time of presentation with ATM symptoms. The most common initial manifestation was acute onset bladder dysfunction and lower limb weakness. In six out of eight cases, magnetic resonance imaging (MRI) of the whole spine showed cervicothoracic cord hyperintensities. Treatment with intravenous methylprednisolone started on day 2 of ATM at a 1g/day dose showed clinical improvement in three patients. Intravenous immunoglobulin therapy (IVIg) at a dose of 25- 30g/day for three days showed improvement in two patients, and one patient improved with plasma exchange following steroid therapy. Conclusions: Most patients with ATM presented with a long latency period (beyond 2 weeks after the initial COVID-19 positive test) and intravenous steroid therapy helps, but most patients seem to require additional IVIg or plasma exchange before showing clinical improvement. We encourage further large scale studies in this regard.
ABSTRACT
Objective: Our review aims to study the significance of the association between the manifestations of Guillain-Barre syndrome (GBS) and COVID-19 immunization, as well as provide medical practitioners with relevant clinical information through a detailed summary of the current cases of GBS related to the COVID-19 vaccines. Additionally, we will shed light on the impact of associated demographic risk factors such as age, gender, and comorbid conditions in the development of GBS post-vaccination. Background: Guillain-Barre syndrome (GBS) is a rare and potentially fatal post-infectious, immune-mediated neuropathy characterized by rapidly progressive weakness and ascending paralysis. As an adverse reaction to the COVID-19 vaccines, GBS is becoming an arising catastrophe increasingly reported as a complication of the COVID-19 vaccines. Design/Methods: A literature search was conducted across four databases: PubMed, PubMed Central, Medline (through PubMed), and Google Scholar using predefined keywords. These keywords included “Guillain Barre Syndrome, ” “COVID-19 vaccination”, “COVID-19”. The search criteria were set to filter cases of GBS in post-COVID-19 vaccination, reported between March 2020 to October 2021. Results: A total of eighteen articles were selected from peer-reviewed journals which documented twenty-eight patients (ages ranged between 20-82 years old) that had developed GBS after receiving COVID-19 vaccinations;fifteen males and thirteen females. GBS side effects were reported with five COVID-19 vaccines including Pfizer, Moderna, Janssen, AstraZeneca (now called Vaxzevria), and a vector-based vaccine. In addition, the average duration between COVID-19 vaccine administration and GBS symptoms onset was noted to be 12.46 days. Conclusions: Although it is too early to draw conclusions concerning GBS following COVID-19 vaccination, we recommend monitoring for cases suggestive of GBS following vaccination and implementing post-vaccination surveillance to ensure adequate data gathering of this outcome, as well as to determine its cause. Additionally, we encourage even further large-scale research into this area.