If Youve Had Guillain Barre Syndrome Will You Get It Again
Source/Disclosures
Source:
Healio Interviews
Disclosures: Fragiel and colleagues report no relevant fiscal disclosures. McDonnell reports no relevant fiscal disclosures.
December 15, 2020
3 min read
Q&A: Guillain-Barre syndrome in patients with COVID-19 requires more than research
Source/Disclosures
Source:
Healio Interviews
Disclosures: Fragiel and colleagues report no relevant financial disclosures. McDonnell reports no relevant financial disclosures.
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Recent inquiry from Kingdom of spain and the United States described Guillain-Barre syndrome — in both novel and recurrent forms — in patients with COVID-nineteen, adding to the growing body of literature on the neurological manifestations of the disease.
In the showtime report, researchers from Spain identified eleven cases of Guillain-Barre syndrome (GBS) amid 71,904 patients with COVID-19 across 61 EDs during a "2-calendar month pandemic peak." They reported a higher relative frequency of GBS in patients with vs. without COVID-xix (0.15% vs. 0.02%; OR = six.xxx; 95% CI, 3.18-12.five) and a higher standardized incidence of the syndrome (9.44 vs. 0.69 cases per 100,000 inhabitants-years; OR = 13.5; 95% CI, 9.87-18.iv). Patients with COVID-19 who developed GBS were more frequently admitted to intensive intendance, but mortality did non increase in these patients compared with control groups.
The researchers noted that additional cases and instance series on the clinical characteristics of GBS in patients with COVID-19 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 group of inquiry suggested "a potential role of SARS-CoV-2 as an additional viral infection causative of GBS."
The 2d study involved the outset known instance of COVID-19 leading to a recurrence of GBS, according to a press release from Rutgers Academy in New Jersey. The patient, a man anile 54 years, had developed GBS on two prior occasions and experienced a third occurrence after testing positive for COVID-19.
"The patient came to the [ED] with complaints of progressive difficulty swallowing, then had a fever for iii days, followed by weakness in the arms, legs and face," Erin McDonnell, a medical student at Rutgers Robert Woods 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 larn more about the example at Rutgers Academy and the connection between GBS and COVID-19.
Q: To your knowledge, this is the outset-ever report of COVID-19 as a trigger for recurrent GBS, correct?
A: Correct. To our noesis, this is the get-go case describing a patient with recurrent GBS secondary to a COVID-19 infection. Abu-Rumeileh and colleagues documented more than 70 cases of patients with GBS secondary to COVID-19, our case represents a patient who had GBS in the past. Most three% to 5% of patients with GBS will have later recurrent episodes. At that place are other case studies describing COVID-19 every bit a trigger for chronic demyelinating polyneuropathy disorders, which is a relapsing-remitting demyelinating disorder.
Q: Should all patients who have had GBS in the past be concerned virtually a recurrence if they go COVID-19?
A: Patients who take had GBS in the past may exist at gamble for GBS recurrence secondary to COVID-19. Statistics demonstrate that, of patients who had GBS in the past, about five% of them experience recurrent symptoms, simply this was earlier COVID-xix. We are notwithstanding learning more than about COVID-19 and its interaction with our own allowed organization.
Q: Does this development tell the states anything most the underlying mechanisms behind GBS?
A: The machinery behind GBS is based on an autoimmune concept called "molecular mimicry." The immune system mistakenly attacks the patient's good for you cells, resulting in nerve impairment. More research is needed to better understand common antigens between the novel coronavirus and specific neuronal tissue.
Q: H ow might this impact the management of COVID-19 ?
A: We recommend close observation for patients with COVID-19 who present to clinicians with neurological and demyelinating symptoms. In addition, nosotros advise clinicians to obtain a thorough history, if possible, to assess whether the patient had GBS in the by.
References:
- Abu-Rumeileh S, et al. J. Neurol. 2020;doi: x.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-first-instance-covid-nineteen-triggering-recurrent-guillain-barre-syndrome. Accessed Dec. fifteen, 2020.
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Source: https://www.healio.com/news/neurology/20201215/guillainbarre-syndrome-in-patients-with-covid19-requires-more-research
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