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1.
Zh Nevrol Psikhiatr Im S S Korsakova ; 122(9): 15-21, 2022.
Article in Russian | MEDLINE | ID: covidwho-2056579

ABSTRACT

Based on the available literature data, the article discusses the prevalence of various forms of damage of the peripheral nervous system in COVID-19 and in the post-COVID period. Information about the clinical features and the course of individual cranial neuropathies, chronic dysimmune neuropathies, Guillain-Barré syndrome, drug-induced neuropathies, fine fiber neuropathy, myasthenia gravis and polyneuropathy of critical conditions was systemized in the context of coronavirus infection. SARS-CoV-2 can trigger various stages of pathogenesis, including neuroimmune ones, which cause long-term consequences of COVID-19, including those associated with the damage of the peripheral nervous system. Awareness of COVID-19-associated pathological conditions will allow assessment of the possible risks of damage of the peripheral nervous system, recognize them at early stages and develop more effective approaches for treatment.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Myasthenia Gravis , COVID-19/complications , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/etiology , Humans , Myasthenia Gravis/complications , Peripheral Nervous System , SARS-CoV-2
2.
Nat Med ; 28(11): 2406-2415, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2036846

ABSTRACT

The neurologic manifestations of acute COVID-19 are well characterized, but a comprehensive evaluation of postacute neurologic sequelae at 1 year has not been undertaken. Here we use the national healthcare databases of the US Department of Veterans Affairs to build a cohort of 154,068 individuals with COVID-19, 5,638,795 contemporary controls and 5,859,621 historical controls; we use inverse probability weighting to balance the cohorts, and estimate risks and burdens of incident neurologic disorders at 12 months following acute SARS-CoV-2 infection. Our results show that in the postacute phase of COVID-19, there was increased risk of an array of incident neurologic sequelae including ischemic and hemorrhagic stroke, cognition and memory disorders, peripheral nervous system disorders, episodic disorders (for example, migraine and seizures), extrapyramidal and movement disorders, mental health disorders, musculoskeletal disorders, sensory disorders, Guillain-Barré syndrome, and encephalitis or encephalopathy. We estimated that the hazard ratio of any neurologic sequela was 1.42 (95% confidence intervals 1.38, 1.47) and burden 70.69 (95% confidence intervals 63.54, 78.01) per 1,000 persons at 12 months. The risks and burdens were elevated even in people who did not require hospitalization during acute COVID-19. Limitations include a cohort comprising mostly White males. Taken together, our results provide evidence of increased risk of long-term neurologic disorders in people who had COVID-19.


Subject(s)
Brain Diseases , COVID-19 , Guillain-Barre Syndrome , Nervous System Diseases , Male , Humans , COVID-19/complications , COVID-19/epidemiology , SARS-CoV-2 , Nervous System Diseases/epidemiology , Guillain-Barre Syndrome/complications
4.
Medicina (Kaunas) ; 58(8)2022 Jul 22.
Article in English | MEDLINE | ID: covidwho-2023895

ABSTRACT

BACKGROUND: Guillain-Barré syndrome (GBS)-a rare condition characterized by acute-onset immune-mediated polyneuropathy-has been registered as a neurological manifestation of COVID-19, suggesting a possible link between these two conditions. METHODS: We report a case series of patients with COVID-19-related GBS hospitalized in the Neurology Department of Colentina Clinical Hospital, Bucharest, Romania, between March 2020 and March 2021. Several variables were analyzed, such as the mean interval between the onset of COVID-19 symptoms and neurological ones, clinical features, treatment course, and outcome. Further on, we conducted a thorough literature review based on the PubMed and ScienceDirect scientific databases. RESULTS: A total of 9 COVID-19 patients developed symptoms of GBS, out of which in 7, it manifested as an acute inflammatory demyelinating polyneuropathy (AIDP). Five patients presented respiratory failure, 2 requiring mechanical ventilation. All patients received a course of intravenous immunoglobulins, 2 additionally requiring plasma exchange. Upon discharge, all but 1 patient (who had not regained the ability to walk) had a positive outcome, and 1 died during admission. In the literature review, we analyzed the published sources at the time of writing. CONCLUSIONS: A link between COVID-19 and GBS might be possible; therefore, increased vigilance is required in the early identification of these cases for prompt diagnosis and treatment. Some notable differences such as an earlier onset of GBS symptoms, higher respiratory dysfunction, and higher mortality rates in COVID-19 patients have been observed between the presentation of GBS in the context of COVID-19 and GBS of other causes.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , COVID-19/complications , Guillain-Barre Syndrome/complications , Humans , Immunoglobulins, Intravenous/therapeutic use , Plasma Exchange , Respiration, Artificial
5.
Health Soc Care Community ; 30(5): e2590-e2603, 2022 09.
Article in English | MEDLINE | ID: covidwho-1985876

ABSTRACT

Guillain-Barré syndrome (GBS) has several enduring effects that can lead to further harm and/or lower quality of life. These effects include falling and body pain, neither of which have been fully explored. This study aims to examine the risk factors associated with falling and potential causes of body pain in a post-GBS population. A cross-sectional survey of 216 participants was conducted using an electronic questionnaire that included. Self-report measures for: overall health, balance, anxiety and depression levels, body pain and demographics related to GBS experience and falls. A large proportion of individuals post-GBS experience ongoing problems beyond those expected with ageing. Comparative tests indicated that people reporting falls in the previous 12 months had: poorer levels of mobility, poorer F-scores, higher levels of body pain, poorer balance, poorer anxiety and depression scores and higher levels of fatigue. Gender did not appear to contribute to falls. Injuries following falls were associated with a lack of physiotherapy postdischarge and time since GBS. In a regression analysis of the identified and expected key variables, age and body pain statistically predicted falls. In over a quarter of cases reported here, respondents did not receive community physiotherapy following hospital discharge. In the midst and aftermath of COVID-19, provision of rehabilitation needs to be recalibrated, not just for COVID patients, but the wider community with ongoing needs. Issues around well-being and quality of life in the post-GBS community also need further consideration.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Adult , Aftercare , Cross-Sectional Studies , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/epidemiology , Humans , Pain/epidemiology , Patient Discharge , Quality of Life
6.
R I Med J (2013) ; 105(7): 23-26, 2022 Sep 01.
Article in English | MEDLINE | ID: covidwho-1981176

ABSTRACT

Neurological symptoms of post-acute sequelae of COVID-19 (PASC), also known as Long COVID, are recognized. Four neurological syndromes (transverse myelitis, ischemic stroke, headache, and Guillain-Barré syndrome) associated with PASC are reviewed here, with a particular focus on issues related to rehabilitation.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , COVID-19/complications , Guillain-Barre Syndrome/complications , Headache , Humans
8.
Pediatr Infect Dis J ; 41(8): e324-e325, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-1948549

ABSTRACT

Guillain-Barré syndrome has been associated with acute severe acute respiratory syndrome coronavirus 2 infection in children. Here, we report a 4-year-old boy who developed Guillain-Barré syndrome in the course of multisystem inflammatory syndrome related to COVID-19.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , COVID-19/complications , Child , Child, Preschool , Family , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/etiology , Humans , Male , Systemic Inflammatory Response Syndrome/complications , Systemic Inflammatory Response Syndrome/diagnosis
9.
Childs Nerv Syst ; 38(10): 2011-2016, 2022 10.
Article in English | MEDLINE | ID: covidwho-1941574

ABSTRACT

Guillain-Barré syndrome has been defined as a post-infectious immune-mediated polyneuropathy. COVID-19 usually presents with respiratory symptoms but can less commonly present with extra-respiratory manifestations such as neurological symptoms. Few cases were published in the literature regarding post-COVID-19 infection Guillain-Barré in the pediatric age group. In this paper, we present a 13-year-old male with possible Guillain-Barré syndrome occurring 2 weeks after a presumed COVID-19 infection. We conducted a systematic review and searched for published pediatric cases until March 2022. We included 35 patients in 25 publications.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Adolescent , COVID-19/complications , Child , Guillain-Barre Syndrome/complications , Humans , Male , SARS-CoV-2
10.
Leg Med (Tokyo) ; 57: 102074, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1900001

ABSTRACT

We presented a case of a 57-year-old female, who was tested positive for SARS-CoV-2 infection and was admitted to a hospital seven days later with signs of early pneumonia. The second day after her admission to the hospital, and nine days after the first positive PCR test, examination showed progressive ascendant weakness of the arms and legs with persisting paresthesia, lab tests showed increased concentration of proteins in the cerebrospinal fluid with albumino-cytological dissociation. She was diagnosed with Guillain-Barré syndrome (GBS). She was on low-flow oxygen support of 3 L/min, with good oxygen saturation (97-99%), without clinical or radiological progression of pneumonia. After receiving a negative PCR test for COVID-19 (11 days after the initial, positive test), four days after admission, she was set to be transferred to a specialized neurology clinic, however, she died unexpectedly during admission. The autopsy showed light to moderate lung edema, signs of moderate to severe coronary atherosclerosis and early myocardial ischemia. Histochemical and immunohistochemical staining of the peripheral nerves sampled from the cervical and brachial plexuses, showed foci of demyelination as well as infiltration with inflammatory cells, predominantly macrophages, and lymphocytes to a lesser degree. It was concluded that the causes of death were a breathing disorder and the paralysis of the diaphragm due to inflammatory polyneuropathy caused by GBS, initiated by SARS-CoV-2 infection. With the lack of similar autopsy cases, we believe that the presented case could be a valuable addition to the understanding of GBS development in SARS-CoV-2 related cases.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Autopsy , COVID-19/complications , Female , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/diagnosis , Humans , Middle Aged , SARS-CoV-2 , Specimen Handling
11.
Rev Peru Med Exp Salud Publica ; 39(1): 111-114, 2022.
Article in Spanish, English | MEDLINE | ID: covidwho-1884807

ABSTRACT

During acute SARS-CoV-2 infection, there is persistent deregulation of the immune system that can last up to 8 months after the acute condition is controlled. This, added to other factors, is possibly associated with an increased risk of the appearance and concurrence of autoimmune diseases. The simultaneous occurrence of GBS and ITP has been rarely reported in the literature, and GBS is rarely associated with another autoimmune disease. We present the case of a man who, one month after his recovery from acute moderate COVID-19, presented concurrent GBS and ITP with an adequate response to treatment.


Durante la infección aguda por el SARVS-CoV-2 se produce una desregulación del sistema inmune que puede durar hasta ocho meses después de controlado el cuadro agudo. Esto, sumado a otros factores, posiblemente este asociado con un aumento del riesgo de aparición y concurrencia de enfermedades autoinmunes. La aparición simultanea del síndrome de Guillain-Barré (SGB) y púrpura trombocitopénica (PTI) se ha reportado poco en la literatura, y el SGB raramente se asocia con otra enfermedad autoinmune. Presentamos el caso de un varón que luego de un mes de tener un cuadro agudo de COVID-19 moderado, presentó concurrentemente SGB y PTI con respuesta adecuada al tratamiento.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Purpura, Thrombocytopenic, Idiopathic , COVID-19/complications , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/therapy , Humans , Male , Purpura, Thrombocytopenic, Idiopathic/complications , SARS-CoV-2
12.
Rev Soc Bras Med Trop ; 55: e03062021, 2022.
Article in English | MEDLINE | ID: covidwho-1869217

ABSTRACT

BACKGROUND: Guillian Barré syndrome (GBS) is an acute autoimmune polyradiculoneuropathy often associated with previous exposure to infectious agents. METHODS: A clinical cohort of 41 patients with GBS admitted to the Base Hospital Institute of the Federal District between May 2017 and April 2019 was followed up for 1 year. Serological tests for arbovirus detection and amplification of nucleic acids using polymerase chain reaction for zika virus (ZIKV), dengue virus (DENV), and chikungunya virus (CHIKV) were performed. RESULTS: The cohort consisted of 61% men with a median age of 40 years, and 83% had GBS-triggering events. A total of 54% had Grade 4 disability, 17% had Grade 3, 12% had Grade 2, 10% had Grade 5, and 7% had Grade 1. The classic form occurred in 83% of patients. Nerve conduction evaluations revealed acute demyelinating inflammatory polyneuropathy (51%), acute motor axonal neuropathy (17%), acute sensory-motor neuropathy (15%), and indeterminate forms (17%). Four patients were seropositive for DENV. There was no laboratory detection of ZIKV or CHIKV infection. Ninety percent of patients received human immunoglobulin. Intensive care unit admission occurred in 17.1% of the patients, and mechanical ventilation was used in 14.6%. One patient died of Bickerstaff's encephalitis. Most patients showed an improvement in disability at 10 weeks of follow-up. CONCLUSIONS: GBS in the Federal District showed a variable clinical spectrum, and it was possible to detect recent exposure to DENV.


Subject(s)
Arboviruses , Guillain-Barre Syndrome , Zika Virus Infection , Zika Virus , Adult , Female , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/epidemiology , Guillain-Barre Syndrome/therapy , Humans , Male , Tertiary Care Centers , Zika Virus Infection/complications , Zika Virus Infection/diagnosis , Zika Virus Infection/epidemiology
13.
J Korean Med Sci ; 37(20): e160, 2022 May 23.
Article in English | MEDLINE | ID: covidwho-1862585

ABSTRACT

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 that may trigger Guillain-Barre syndrome (GBS) in selected patients. We describe a case of GBS presenting as marked finger extensor weakness in a 73-year-old woman with COVID-19. Her clinical and electrophysiological findings were consistent with a diagnosis of acute motor axonal neuropathy subtype of GBS with prominent finger dropping. Treatment with intravenous immunoglobulin for 5 days completely resolved her finger extension weakness after 19 months, although other involved extremities recovered earlier at 3 months. This study highlights that COVID-19-associated GBS can present in various forms aside from the classic variant, even in patients without any COVID-19 symptoms. Therefore, it is important to always consider the diagnosis of GBS in patients with COVID-19.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Aged , COVID-19/complications , Female , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/diagnosis , Humans , Immunoglobulins, Intravenous/therapeutic use , Muscle Weakness , SARS-CoV-2
15.
Ethiop J Health Sci ; 32(1): 205-208, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1835342

ABSTRACT

BACKGROUND: Since the outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV2) in December 2019, there have been some case reports of Coronavirus disease 19 (COVID 19) associated Guillain-Barré Syndrome (GBS). GBS is an inflammatory polyradiculoneuropathy associated with numerous viral and bacterial infections. Here we describe the case of an Ethiopian man with a typical clinical and electrophysiological manifestation of GBS. CASE PRESENTATION: A 70-year-old male presented with four days history of progressive and ascending bilateral limbs weakness which end up with respiratory failure. He had an antecedent headache, loss of appetite, and generalized fatigue. Electrophysiological studies showed Acute Motor and Sensory Axonal Neuropathy whereas and cerebrospinal fluid analysis revealed albuminocytologic dissociation with positive preintubation SARS CoV2 test. He was treated with supportive care and recovered successfully. CONCLUSION: This case illustrates one of the few occasions when patients with mild COVID-19 develop severe neurologic manifestations. Seemingly, early identification and management can improve clinical outcomes. We would like to emphasize the need to consider screening for SARS CoV-2 in patients presenting with GBS.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , Aged , COVID-19/complications , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/diagnosis , Headache , Humans , Male , SARS-CoV-2
16.
QJM ; 114(9): 625-635, 2021 Nov 13.
Article in English | MEDLINE | ID: covidwho-1746245

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been linked to the Guillain-Barré syndrome (GBS). The objective of the present study is to identify specific clinical features of cases of GBS reported in the literature associated with SARS-CoV-2 infection. We searched Pubmed, and included single case reports and case series with full text in English, reporting original data of patients with GBS and a confirmed recent SARS-CoV-2 infection. Clinical data were extracted. We identified 28 articles (22 single case reports and 6 case series), reporting on a total of 44 GBS patients with confirmed SARS-CoV-2 infection. SARS-CoV-2 infection was confirmed through serum reverse transcriptase-polymerase chain reaction in 72.7% of cases. A total of 40 patients (91%) had symptoms compatible with SARS-CoV-2 infection before the onset of the GBS. The median period between the onset of symptoms of SARS-CoV-2 infection and symptoms of the GBS was 11.2 days (range, 2-23). The most common clinical features were: leg weakness (61.4%), leg paresthesia (50%), arm weakness (50.4%), arm paresthesia (50.4%), hyporeflexia/areflexia (48%) and ataxia (22.7%). In total, 38.6% (n = 17) were found to have facial paralysis. Among 37 patients in whom nerve-conduction studies and electromyography were performed, of which 26 patients (59.1%) were consistent with the acute inflammatory demyelinating polyneuropathy subtype of the GBS. The present retrospective analysis support the role of the SARS-CoV-2 infection in the development of the GBS, may trigger GBS as para-infectious disease, and lead to SARS-CoV-2-associated GBS.


Subject(s)
COVID-19 , Communicable Diseases , Guillain-Barre Syndrome , Guillain-Barre Syndrome/complications , Humans , Retrospective Studies , SARS-CoV-2
18.
J Neuroimmunol ; 366: 577842, 2022 05 15.
Article in English | MEDLINE | ID: covidwho-1720453

ABSTRACT

Various neurological complications have been described in COVID-19 patients, especially Guillain-Barre syndrome (GBS). The underlying mechanisms on the association between SARS-CoV-2 infection and GBS remain unclear, but several hypotheses have been proposed. It seems that post-SARS-CoV-2 GBS shares many characteristics with classic post-infectious GBS; however, it may occur in sedated and intubated patients hospitalized in the intensive care unit for SARS-CoV-2 acute respiratory distress syndrome, which presents challenges in the diagnosis and treatment of GBS. In this study, we describe three cases of post-SARS-CoV-2 GBS that were hospitalized in the intensive care unit.


Subject(s)
COVID-19 , Guillain-Barre Syndrome , COVID-19/complications , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/diagnosis , Humans , Intensive Care Units , SARS-CoV-2
19.
Medicine (Baltimore) ; 101(6): e28758, 2022 Feb 11.
Article in English | MEDLINE | ID: covidwho-1708012

ABSTRACT

RATIONALE: Sleep disturbance is commonly noted after Guillain-Barré syndrome (GBS) and is often caused by persistent discomfort after disease survival. Intravascular laser irradiation of blood (ILIB) has been shown to be effective in pain modulation owing to the influence of nociceptive signals in the peripheral nervous system. We investigated the application of ILIB on post-Oxford -AstraZeneca vaccination GBS and evaluated its effect on sleep quality. PATIENT CONCERNS: A 48-year-old woman was subsequently diagnosed with GBS after Oxford-AstraZeneca vaccination. The patient was discharged after a 5-day course of intravenous immunoglobulin administration. However, 1 week after discharge, the previously relieved symptoms flared with accompanying sleep disturbance. DIAGNOSIS AND INTERVENTIONS: The patient was diagnosed with post-vaccination GBS, and persistent pain and sleep disturbances persisted after disease survival. ILIB was performed. OUTCOMES: We used the Pittsburgh Sleep Quality Index before and after intravascular laser irradiation. There was a marked improvement in the sleep duration, efficiency, and overall sleep quality. The initial score was 12 out of 21 and the final score was 7 out of 21. LESSONS: We found that ILIB was effective in pain modulation in post-vaccination GBS and significantly improved sleep quality.


Subject(s)
ChAdOx1 nCoV-19/adverse effects , Guillain-Barre Syndrome/chemically induced , Low-Level Light Therapy , Sleep Wake Disorders/therapy , COVID-19 Vaccines , ChAdOx1 nCoV-19/administration & dosage , Female , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/drug therapy , Humans , Immunoglobulins, Intravenous/administration & dosage , Immunoglobulins, Intravenous/therapeutic use , Middle Aged , Pain , Sleep , Sleep Wake Disorders/etiology , Vaccination/adverse effects
20.
Pediatr Infect Dis J ; 40(7): e274-e276, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1700567

ABSTRACT

Underlying mechanisms on the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and neurologic complications are still poorly understood. Cases of Guillain-Barré Syndrome (GBS) have been linked to the SARS-CoV-2 infection as the result of dysregulated immune response with damage in neuronal tissues. In the current report, we present the first pediatric case of GBS with detection of SARS-CoV-2 in the cerebrospinal fluid (CFS). This unique case of COVID-19-associated GBS with detection of SARS-CoV-2 RNA in the CSF indicates direct viral involvement inducing peripheral nerve inflammation.


Subject(s)
COVID-19/cerebrospinal fluid , COVID-19/diagnosis , Guillain-Barre Syndrome/complications , RNA, Viral/cerebrospinal fluid , Adolescent , COVID-19/complications , Cauda Equina/diagnostic imaging , Cauda Equina/pathology , Cauda Equina/virology , Female , Guillain-Barre Syndrome/virology , Humans , Inflammation/virology , Magnetic Resonance Imaging , SARS-CoV-2/isolation & purification
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