Does Having Guillian Barre Syndrome Increase Chances of Getting Again
Source/Disclosures
Source:
Healio Interviews
Disclosures: Fragiel and colleagues report no relevant financial disclosures. McDonnell reports no relevant fiscal disclosures.
December 15, 2020
three min read
Q&A: Guillain-Barre syndrome in patients with COVID-19 requires more enquiry
Source/Disclosures
Source:
Healio Interviews
Disclosures: Fragiel and colleagues study no relevant financial disclosures. McDonnell reports no relevant financial disclosures.
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Recent research from Spain and the Us described Guillain-Barre syndrome — in both novel and recurrent forms — in patients with COVID-19, adding to the growing trunk of literature on the neurological manifestations of the affliction.
In the first report, researchers from Spain identified xi cases of Guillain-Barre syndrome (GBS) among 71,904 patients with COVID-nineteen across 61 EDs during a "2-month pandemic summit." They reported a higher relative frequency of GBS in patients with vs. without COVID-19 (0.xv% vs. 0.02%; OR = 6.30; 95% CI, 3.18-12.5) and a higher standardized incidence of the syndrome (nine.44 vs. 0.69 cases per 100,000 inhabitants-years; OR = 13.5; 95% CI, 9.87-18.4). Patients with COVID-19 who developed GBS were more ofttimes admitted to intensive care, merely mortality did non increment in these patients compared with command groups.
The researchers noted that additional cases and case series on the clinical characteristics of GBS in patients with COVID-nineteen were published as they prepared their manuscript. The results in those reports were "mainly consistent" with their findings, they wrote, and concluded that — when taken together — this grouping of research suggested "a potential role of SARS-CoV-2 as an boosted viral infection causative of GBS."
The second report involved the first known instance of COVID-nineteen leading to a recurrence of GBS, according to a printing release from Rutgers University in New Jersey. The patient, a man anile 54 years, had adult GBS on two prior occasions and experienced a third occurrence after testing positive for COVID-nineteen.
"The patient came to the [ED] with complaints of progressive difficulty swallowing, then had a fever for three days, followed past weakness in the artillery, legs and face," Erin McDonnell, a medical student at Rutgers Robert Forest Johnson Medical School, said in the press release. "His symptoms were worse this time than in previous episodes. He has since recovered."
Healio Neurology spoke with McDonnell to learn more about the case at Rutgers University and the connexion between GBS and COVID-19.
Q: To your knowledge, this is the commencement-ever report of COVID-19 every bit a trigger for recurrent GBS, correct?
A: Correct. To our cognition, this is the showtime case describing a patient with recurrent GBS secondary to a COVID-19 infection. Abu-Rumeileh and colleagues documented more 70 cases of patients with GBS secondary to COVID-19, our case represents a patient who had GBS in the past. Almost three% to 5% of patients with GBS will take afterwards recurrent episodes. There are other case studies describing COVID-nineteen as a trigger for chronic demyelinating polyneuropathy disorders, which is a relapsing-remitting demyelinating disorder.
Q: Should all patients who take had GBS in the by be concerned about a recurrence if they get COVID-19?
A: Patients who have had GBS in the past may be at take a chance for GBS recurrence secondary to COVID-19. Statistics demonstrate that, of patients who had GBS in the past, about five% of them feel recurrent symptoms, only this was before COVID-19. We are nonetheless learning more than about COVID-19 and its interaction with our own immune organisation.
Q: Does this development tell united states of america anything nigh the underlying mechanisms behind GBS?
A: The mechanism backside GBS is based on an autoimmune concept called "molecular mimicry." The immune system mistakenly attacks the patient'south healthy cells, resulting in nerve damage. More research is needed to better understand common antigens betwixt the novel coronavirus and specific neuronal tissue.
Q: H ow might this impact the management of COVID-nineteen ?
A: We recommend shut ascertainment for patients with COVID-19 who nowadays to clinicians with neurological and demyelinating symptoms. In improver, we advise clinicians to obtain a thorough history, if possible, to assess whether the patient had GBS in the past.
References:
- Abu-Rumeileh S, et al. J. Neurol. 2020;doi: ten.1007/s00415-020-10124-x.
- Fragiel M, et al. Ann Neurol. 2020;doi:10.1002/ana.25987.
- Rutgers Today. Rutgers reports first instance of COVID-19 triggering recurrent Guillain-Barre syndrome. Available at: https://www.rutgers.edu/news/rutgers-reports-outset-instance-covid-19-triggering-recurrent-guillain-barre-syndrome. Accessed Dec. 15, 2020.
Source: https://www.healio.com/news/neurology/20201215/guillainbarre-syndrome-in-patients-with-covid19-requires-more-research
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