No conclusive association between COVID-19 infection and Guillain-Barre syndrome, finds study

COVID-19 been linked to many diseases and disorders since the beginning of the pandemic, including diabetes, kidney disease and heart disease. Early on, one of the diseases COVID-19 was linked to was Guillain-Barre syndrome. Guillain-Barre syndrome (GBS) is a rare neurological disorder and an autoimmune disease in which the immune system starts attacking the peripheral nervous system. From mild weakness to paralysis, the US National Institutes of Health (NIH) explains that GBS has a number of symptoms and can affect anyone and at any age. GBS is usually reversible with proper immune therapy, but it can cause prolonged and debilitating paralysis that may lead to irreversible neurological damage too. Link between COVID-19 and Guillain-Barre A study published in the New England Journal of Medicine in April 2020 described how some COVID-19 patients from northern Italy had been found to have symptoms resembling those of GBS. In these patients, the GBS symptoms emerged a few days after COVID-19 symptom onset and included lower limb weakness, a tingling sensation, facial paralysis and impaired limb coordination. Providing immunoglobulin therapy strengthened these patients’ immune response and helped them recover slowly yet steadily. Many other case studies and reports from around the world have also indicated that patients of COVID-19 are developing GBS symptoms in rare cases. Another study published in Neurologia in October 2020 suggests that not only do coronaviruses affect various parts of the nervous system, and therefore have the potential to trigger GBS along with other conditions like viral encephalitis and cerebrovascular diseases, GBS itself is frequently associated with viral and bacterial infections like influenza, HIV and herpes. The exact mechanism behind this association, however, was unknown. No epidemiological and phenotypic association found A new UK-based study published in the journal Brain sheds some light on this suspected association between COVID-19 and GBS. Conducted by researchers at the University College London, this study is primarily based on data about GBS cases reported to the UK’s National Immunoglobulin Database between 2016 and 2019 as compared to GBS cases reported during the COVID-19 pandemic. The scientists also separately collected data from the British Peripheral Nerve Society regarding the number of GBS cases that emerged during the pandemic. The clinical features of reported cases, definite or probable outcomes and investigative findings of all these cases were compared. The researchers found that the incidence of GBS cases treated in the UK between 2016 to 2019 was 1.65-1.88 per 100,000 individuals per year. Compared to the same months in 2016-2019, the number of GBS cases in the UK between March and May 2020, when the COVID-19 pandemic peaked in the UK, actually decreased. In fact, case correlation between GBS and COVID-19 was not conclusively established since the regions where the incidences of either occurred varied by a lot. The researchers observed that even in cases where GBS and COVID-19 occurred together, there was no significant difference to be found in the pattern of weakness, functional nadir or lowest point, neurophysiology, cerebrospinal fluid findings or other outcomes between them and GBS cases without COVID-19. However, the scientists did find that intubation and the need for ventilation support were more frequent in COVID-19 patients with GBS, which is more likely to be due to the involvement of the lungs. They concluded that though it cannot be entirely ruled out, the fact that GBS incidence has actually fallen during the COVID-19 pandemic indicates that there is no conclusive epidemiological or phenotypic evidence to support the link between the two diseases. In fact, these scientists believe that the transmission of pathogens more conclusively linked with GBS, like Campylobacter jejuni and other respiratory viruses, have decreased during the pandemic due to lockdown and social distancing measures. For more information, read our article on Guillain-Barre syndrome. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.