COVID-19-Associated Guillain-Barre Syndrome: Atypical Para-infectious Profile, Symptom Overlap, and Increased Risk of Severe Neurological Complications.
Abstract
The concurrence of COVID-19 with Guillain-Barre syndrome (GBS) can increase the likelihood
of neuromuscular respiratory failure, autonomic dysfunction, and other life-threatening
symptoms. Currently, very little is known about the underlying mechanisms, clinical
course, and prognostic implications of comorbid COVID-19 in patients with GBS. We
reviewed COVID-19-associated GBS case reports published since the outbreak of the
pandemic, with a database search up to August 2020, including a manual search of the
reference lists for additional relevant cases. Fifty-one (51) case reports of COVID-19
patients (aged 23-84 years) diagnosed with GBS in 11 different countries were included
in this review. The results revealed atypical manifestations of GBS, including para-infectious
profiles and onset of GBS without antecedent COVID-19 symptoms. Although all tested
patients had signs of neuroinflammation, none had SARS-CoV-2 in the cerebrospinal
fluid (CSF), and only four (4) patients had antiganglioside antibodies. The majority
had a 1- to 10-day time interval between the onset of COVID-19 and GBS symptoms, and
many had a poor outcome, with 20 out of the 51 (39.2%) requiring mechanical ventilation,
and two deaths within 12 to 24 h. The atypical manifestations of COVID-19-associated
GBS, especially the para-infectious profile and short time interval between the onset
of the COVID-19 and GBS symptoms, increase the likelihood of symptom overlap, which
can complicate the treatment and result in worsened disease progression and/or higher
mortality rates. Inclusion of a neurological assessment during diagnosis of COVID-19
might facilitate timely identification and effective management of the GBS symptoms
and improve treatment outcome.
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https://hdl.handle.net/10161/21962Published Version (Please cite this version)
10.1007/s42399-020-00646-wPublication Info
Kajumba, Mayanja M; Kolls, Brad J; Koltai, Deborah C; Kaddumukasa, Mark; Kaddumukasa,
Martin; & Laskowitz, Daniel T (2020). COVID-19-Associated Guillain-Barre Syndrome: Atypical Para-infectious Profile, Symptom
Overlap, and Increased Risk of Severe Neurological Complications. SN comprehensive clinical medicine, 2(12). pp. 1-13. 10.1007/s42399-020-00646-w. Retrieved from https://hdl.handle.net/10161/21962.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Bradley Jason Kolls
Associate Professor of Neurology
As a neurointensivist, I am interested in improving our ability to monitor brain function
and impact of therapy on our patients in the critical care setting. To this end I
am developing new approaches to patient monitoring that will integrate patient physiologic
monitoring with brain activity recorded by electroencephalography (EEG). On the basic
science side I am interested in the central nervous system's response to injury. Although
much attention has been focused on closed head injury as
Deborah Koltai
Associate Professor in Psychiatry and Behavioral Sciences
1) Investigation of factors related to care of epilepsy patients in Uganda, Africa
to inform capacity building and infrastructure strengthening efforts. Studies have
involved a pursuit of understanding the cultural context and its impact on health
care delivery and utilization.2) Development and psychometric validation of neuropsychological
and behavioral instruments.3) The effect of psychological interventions on the abilities
and adjustment of dementia patients and thos
Daniel Todd Laskowitz
Professor of Neurology
Our laboratory uses molecular biology, cell culture, and animal modeling techniques
to examine the CNS response to acute injury. In particular, our laboratory examines
the role of microglial activation and the endogenous CNS inflammatory response in
exacerbating secondary injury following acute brain insult. Much of the in vitro work
in this laboratory is dedicated to elucidating cellular responses to injury with the
ultimate goal of exploring new therapeutic interventions in the clinical settin
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