ABSTRACT
Guillain-Barre syndrome (GBS) is an immune-mediated acute polyradiculoneuropathy and commonly occurs after a preceding infection or immunization sequalae. Following the severe acute respiratory syndrome-coronavirus-2 virus pandemic with co-introduction of massive vaccinations, several GBS cases associated with coronavirus disease 2019 (COVID-19) infection per se or after vaccination for COVID-19 were reported internationally. Herein, we report two cases of Korean GBS presenting with tetraplegia after two different COVID-19 vaccinations (42-year old man by AstraZeneca and 48-year woman by Pfizer vaccines) within four weeks after vaccination. The patients were diagnosed with clinical examination, serial electromyography, and compatible laboratory results and improved after comprehensive rehabilitative treatment and intravenous immunoglobulin therapy. Furthermore, we performed an electrodiagnostic follow-up study of each case to examine their unique characteristics.
Subject(s)
BNT162 Vaccine/adverse effects , ChAdOx1 nCoV-19/adverse effects , Guillain-Barre Syndrome/pathology , Quadriplegia/pathology , Vaccination/adverse effects , Adult , BNT162 Vaccine/immunology , COVID-19/prevention & control , ChAdOx1 nCoV-19/immunology , Electromyography , Female , Guillain-Barre Syndrome/rehabilitation , Guillain-Barre Syndrome/therapy , Humans , Immunoglobulins, Intravenous/therapeutic use , Male , Middle Aged , Quadriplegia/rehabilitation , Quadriplegia/therapy , SARS-CoV-2/immunologyABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) has been an epidemic in the Republic of Korea since the first patient who came in China was confirmed as having the disease on January 19, 2020. Therefore, surgery for COVID-19-related patients is expected to increase. CASE: We experienced two cases of COVID-19-related patients who underwent surgery for femur fracture under general anesthesia. In one case, infection control to prevent transmission was achieved, while in the second case, healthcare workers were exposed to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). CONCLUSIONS: In areas where there is COVID-19 epidemic, SARS-CoV-2 real-time polymerase chain reaction should be performed before surgery in patients with symptoms of respiratory infection such as fever, cough, and sputum, or for those in whom the possibility of COVID-19 cannot be completely excluded. Efforts should be made to prevent healthcare worker's exposure and the contamination of the operating room.