Link between COVID-19 and Guillain-Barre Syndrome

Does COVID-19 cause Guillain-Barre Syndrome? A study recently published in Brain describes the results of a group of researchers examining the relationship between the two.

As of late 2019, COVID-19 infections have been linked to a wide variety of symptoms and diseases. COVID-19-related neurological diseases are a cause for concern, particularly Guillain-Barré Syndrome (GBS).

GBS is characterized by an impaired immune response that attacks the nerves. Symptoms include tingling or weakness in the limbs, which often spread to the entire body and cause paralysis. Guillain-Barré syndrome typically occurs a few days or weeks after bacterial or viral infections.

The relationship between COVID-19 and GBS was first called into question in late January 2020 when an asymptomatic COVID-19 patient developed GBS symptoms eight days after being diagnosed. Following this, onset of GBS after catching COVID-19 was also reported in five other patients.

In these cases, researchers have tried to understand whether COVID-19 is triggering the onset of GBS or whether it is simply a fluke. Neuroscientists at University College London conducted a study to investigate the link between COVID-19 and Guillain-Barre Syndrome.

The researchers used information from the UK's National Immunoglobulin Database to determine the number of GBS hospital cases from January 1 to May 31, 2020. They then compared the information with data from previously reported cases from the European International GBS Outcome Study. The symptoms and characteristics of GBS were analyzed between those diagnosed during the pandemic and those diagnosed before the pandemic. The study also looked at population demographics and the differences between each physical characteristic. To weigh the association between GBS and COVID-19, the likelihood of illness was broken down into susceptibility to "definite COVID-19", "probable COVID-19" and "non-COVID-19". The diagnosis of Guillain-Barré syndrome within six weeks after the COVID-19 illness was confirmed as a "clear" connection, longer periods were classified as "likely".

COVID-19 is unlikely to cause Guillain-Barre syndrome

The average number of GBS cases reported in the UK between 2016 and 2019 was 1,098 per year (these results were in line with the numbers seen in North America and Europe). The number of COVID-19 infections in March, April and May 2020 was between 4000 and 6000 per day.

If there is a link between COVID-19 infections and Guillain-Barre syndrome, the number of GBS diagnoses should also have increased during this time. However, the researchers found the opposite: GBS cases were significantly lower in these months than they were in 2016-19. They also found no correlation between the two in different regions of the UK.

The statistical analysis showed that the probability of Guillain-Barré syndrome occurring is 0.016 cases per 1,000 COVID-19 infections. The study found no likely relationship between COVID-19 and Guillain-Barre Syndrome and no clear GBS symptoms that could have been caused by COVID-19.

Although the researchers couldn't find a definitive relationship between COVID-19 and Guillain-Barre Syndrome, the cause of very rare cases cannot be overlooked. Future studies are needed to examine the reported COVID-19-associated GBS cases and understand the real effects of COVID-19 on brain health.

Written by Melody Sayrany

References:

Uclnews. (n.d.). No association between COVID-19 and Guillain-Barré syndrome. Retrieved December 20, 2020 from https://www.eurekalert.org/pub_releases/2020-12/ucl-nab121120.php

Keddie, S., Lunn, M.P., Foster, M., Machado, P.M., Pipis, M., Mousele, C.,. . . Paterson, R.W. (n.d.). Epidemiological studies and cohort studies show no association between COVID-19 and Guillain-Barre syndrome. Brain, 2-32. doi: 10.37473 / dac / 10.1101 / 2020.07.24.20161471
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