Guillain-Barré syndrome in post-COVID-19 syndrome: Literature review
Keywords:Guillian-Barré syndrome; Coronavirus infections; Neurology; Internal medicine; Public health.
Guillain-Barré Syndrome (GBS) is an acute immune-mediated polyneuropathy, also determined as acute idiopathic polyradiculoneuropathy, given by an acquired autoimmune disorder. This syndrome is marked by the loss of the myelin sheath and tendon reflexes, encompassing acute immunomediated polyneuropathies, which can be subdivided into two types: demyelinating and axonal, which can be triggered by an immune trigger due to viral, bacterial, fungal etiology. or genetics. When it comes to GBS by etiology by SARS-COV-2, there are reports in the literature of affected patients who developed neurological manifestations in the post-COVID-19 syndrome, determined by the presentation of symptoms for more than three months after the acute phase of the disease. In this sense, this article aims to describe the main clinical manifestations, diagnosis and treatment for patients affected by GBS in the post-COVID-19 syndrome. A retrospective, bibliographic review was carried out in the MEDLINE / PubMed and LILACS databases, using the descriptors / keywords and Boolean operator: "Coronavirus Infections" AND "Guillain-Barré Syndrome". 86 articles were located and after applying the inclusion and exclusion criteria, eight case report articles were included for analysis. The sex most affected was male (75%), with a mean age of 52 years with a minimum of 21 years and a maximum of 66 years. The presentation symptoms for COVID-19 ranged from asymptomatic (12.5%) to symptomatic (87.5%) with the presence of cough (75%), fever (62.5%) and others. The first neurological manifestation after COVID-19 was in 13 days, with the main neurological manifestations being bilateral peripheral facial paralysis, dysarthria and areflexia. When analyzing the cerebrospinal fluid, there was the presence of albuminocytological dissociations (87.5%) and olioclonal bands (12.8%). When electroneuromyography was performed, the neurophysiological subtypes found were classified mostly by demyelinating neuropathy (50%), with its main variant for GBS for classical motor sensitivism (62.5%). Most patients, after diagnosis of the main variant for GBS (87.5%), were treated with intravenous immunoglobulin (75%) and plasmapheresis (12.5%), with favorable clinical evolution and later hospital discharge.
Assini, A., Benedetti, L., Di Maio, S., Schirinzi, E., & Del Sette, M. (2020). New clinical manifestation of COVID-19 related Guillain-Barrè syndrome highly responsive to intravenous immunoglobulins: two Italian cases. Neurological Sciences, 41, 1657-1658.
Caamaño, D. S. J., & Beato, R. A. (2020). Facial diplegia, a possible atypical variant of Guillain-Barré Syndrome as a rare neurological complication of SARS-CoV-2. Journal of Clinical Neuroscience, 77, 230-232.
Carlos, W. G., Dela Cruz, C. S., Cao, B., Pasnick, S., & Jamil, S. (2020). Novel Wuhan (2019-nCoV) Coronavirus. Am J Respir Crit Care Med, P7-P8.
Chan, J. L., Ebadi, H., & Sarna, J. R. (2020). Guillain-Barré syndrome with facial diplegia related to SARS-CoV-2 infection. Canadian Journal of Neurological Sciences, 47(6), 852-854.
Chevret, S., Hughes, R. A., & Annane, D. (2017). Plasma exchange for Guillain‐Barré syndrome. Cochrane Database of Systematic Reviews, (2).
Fernández-Domínguez J, Ameijide-Sanluis E, García-Cabo C, García-Rodríguez R, Mateos V. Miller Fisher-like syndrome related to SARS-CoV-2 infection (COVID-19). J Neurol 2020; 267: 2495-6.
Gittermann, L. T., Feris, S. V., & von Oetinger Giacoman, A. (2020). Relation between COVID-19 and Guillain-Barré syndrome in adults: A systematic review. Neurología (English Edition).
Gutiérrez-Ortiz, C., Méndez-Guerrero, A., Rodrigo-Rey, S., San Pedro-Murillo, E., Bermejo-Guerrero, L., Gordo-Mañas, R., ... & Benito-León, J. (2020). Miller Fisher Syndrome and polyneuritis cranialis in COVID-19. Neurology, 95(5), e601-e605.
Hutchins, K. L., Jansen, J. H., Comer, A. D., Scheer, R. V., Zahn, G. S., Capps, A. E., ... & Koontz, N. A. (2020). COVID-19–associated bifacial weakness with paresthesia subtype of Guillain-Barré syndrome. American Journal of Neuroradiology, 41(9), 1707-1711.
Lantos, J. E., Strauss, S. B., & Lin, E. (2020). COVID-19–associated miller fisher syndrome: MRI findings. American Journal of Neuroradiology, 41(7), 1184-1186.
Manganotti P, Pesavento V, Buoite Stella A, Bonzi L, Campagnolo E, Bellavita G, et al. Miller Fisher syndrome diagnosis and treatment in a patient with SARS-CoV-2. J Neurovirol 2020; 26: 605-6.
Montalvan, V., Lee, J., Bueso, T., De Toledo, J., & Rivas, K. (2020). Neurological manifestations of COVID-19 and other coronavirus infections: a systematic review. Clinical Neurology and Neurosurgery, 194, 105921.
Ottaviani, D., Boso, F., Tranquillini, E., Gapeni, I., Pedrotti, G., Cozzio, S., ... & Giometto, B. (2020). Early Guillain-Barré syndrome in coronavirus disease 2019 (COVID-19): a case report from an Italian COVID-hospital. Neurological Sciences, 41, 1351-1354.
Paybast, S., Gorji, R., & Mavandadi, S. (2020). Guillain-Barré syndrome as a neurological complication of novel COVID-19 infection: a case report and review of the literature. The neurologist, 25.
Payus, A. O., Lin, C. L. S., Noh, M. M., Jeffree, M. S., & Ali, R. A. (2020). SARS-CoV-2 infection of the nervous system: A review of the literature on neurological involvement in novel coronavirus disease-(COVID-19). Bosnian journal of basic medical sciences, 20(3), 283.
Reyes‐Bueno, J. A., García‐Trujillo, L., Urbaneja, P., Ciano‐Petersen, N. L., Postigo‐Pozo, M. J., Martínez‐Tomás, C., & Serrano‐Castro, P. J. (2020). Miller‐Fisher syndrome after SARS‐CoV‐2 infection. European journal of neurology, 27(9), 1759-1761.
Sedaghat, Z., & Karimi, N. (2020). Guillain Barre syndrome associated with COVID-19 infection: a case report. Journal of Clinical Neuroscience, 76, 233-235.
Uncini, A., Notturno, F., & Kuwabara, S. (2020). Hyper-reflexia in Guillain-Barré syndrome: systematic review. Journal of Neurology, Neurosurgery & Psychiatry, 91(3), 278-284.
Wang, L., Shen, Y., Li, M., Chuang, H., Ye, Y., Zhao, H., & Wang, H. (2020). Clinical manifestations and evidence of neurological involvement in 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis. Journal of neurology, 1-13.
Whittaker, A., Anson, M., & Harky, A. (2020). Neurological manifestations of COVID‐19: a systematic review and current update. Acta Neurologica Scandinavica, 142(1), 14-22.
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Copyright (c) 2021 Thyago de Oliveira Afonso; Samuel Lopes dos Santos; Ranniely Kauany Bezerra da Silva; Douglas Rogério Freitas de Souza; Gustavo Baroni Araújo; Igor de Oliveira Carvalho; João Victor Filgueiras Mota; Layanne Cavalcante de Moura; Guilherme Dantas Borges; Ana Izabel Aparecida Vieira; Bernardo da Luz Barbosa; Ronnyele Cássia Araujo Santos; Célio Pereira de Sousa Júnior; Murilo de Jesus Porto; Jaciara Pinheiro de Souza; Vanessa Cristina de Almeida Viana; Filipe Matheus Cardoso da Silva; Amanda Costa Maciel; Joelma Maria dos Santos da Silva Apolinário; Rafaela Alves de Oliveira; Erica Patrícia Dias de Sousa; Adriano Nogueira da Cruz; Mariana Teixeira da Silva; Maria da Cruz Alves da Silva; Francisco Iago Fonseca Faria; Ricardo Mesquita Lobo; Alane da Silva Tôrres; Samara Atanielly Rocha
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