Characterization of post-COVID-19 Guillain-Barré syndrome in a private clinic in the inner Amazon – case series report

Authors

DOI:

https://doi.org/10.33448/rsd-v11i15.37532

Keywords:

Guillain-Barré Syndrome; COVID-19; SARS-CoV-2.

Abstract

Objectives: to report cases of post-COVID-19 Guillain-Barré Syndrome in a city in the interior of the Amazon, to characterize the evolution of the clinical picture, diagnosis and outcome of the disease, to portray the similarities and differences between patients and to highlight the importance of valuing the Post-COVID-19 Guillain-Barré Syndrome. Methods: this is a case series composed of six patients with a condition compatible with Guillain-Barré Syndrome related to previous infection by COVID-19. It is an observational and descriptive study and the data were collected retrospectively from the analysis of the medical records of a private clinic located in Santarém, state of Pará, Brazil. Results and Discussion: All patients had a clinical and laboratory diagnosis of COVID-19, followed by Guillain-Barré Syndrome. In this study, motor impairment was predominant and did not always follow an ascending pattern. The cerebrospinal fluid (CSF) examination had a variable result and without the typical abnormalities. Electroneuromyography revealed that axonal involvement was predominant. Most patients evolved with functional recovery and only one of them presented no improvement. Treatment with intravenous immunoglobulin appears to have contributed to a positive outcome. The data found are compatible with studies in other regions of the world. Conclusion: Post-COVID-19 Guillain-Barré Syndrome may have different clinical, laboratory and neurophysiological manifestations than usual and may have a variable course, with early diagnosis being essential for a more assertive treatment and lower risk of sequelae. This has become a challenge in remote places and small towns in the Amazon, where access to health care is more precarious.

References

Bonita, R., Beaglehole, R., & Kjellstrom, T. (2010). Epidemiologia básica (2ªed.). São Paulo: Santos. https://ria.ufrn.br/jspui/handle/123456789/1006

Brasil. (2020). Protocolo de Manejo Clínico do Coronavírus (COVID-19) na Atenção Primária à Saúde. Secretaria de Atenção Primária à Saúde (SAPS), 9, 1–41. https://portaldeboaspraticas.iff.fiocruz.br/biblioteca/protocolo-de-manejo-clinico-do-coronavirus-covid-19-na-atencao-primaria-a-saude/

Brasil. (2022). Secretaria de Vigilância à Saúde (SVS): Guia de vigilância Epidemiológica. Ministério da Saúde. Coronavírus Brasil (covid.saude.gov.br).

Brooks, J. E., Mix, F. M., Buck, J. C., & Walters, R. A. (2021). COVID-19-Induced Guillain-Barré Syndrome. Cureus, 13(11), 11–13. https://doi.org/10.7759/cureus.19809

Burns, T. M. (2008). Guillain-Barré syndrome. Seminars in Neurology, 28(2), 152–167. https://doi.org/10.1055/s-2008-1062261

Chen, N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y., Qiu, Y., Wang, J., Liu, Y., Wei, Y., Xia, J., Yu, T., Zhang, X., & Zhang, L. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet, 395(10223), 507–513. https://doi.org/10.1016/S0140-6736(20)30211-7

Doets, A. Y., Verboon, C., van den Berg, B., Harbo, T., Cornblath, D. R., Willison, H. J., Islam, Z., Attarian, S., Barroso, F. A., Bateman, K., Benedetti, L., van den Bergh, P., Casasnovas, C., Cavaletti, G., Chavada, G., Claeys, K. G., Dardiotis, E., Davidson, A., van Doorn, P. A., … Zivkovic, S. (2018). Regional variation of Guillain-Barré syndrome. Brain, 141(10), 2866–2877. https://doi.org/10.1093/brain/awy232

Fokke, C., Van Den Berg, B., Drenthen, J., Walgaard, C., Van Doorn, P. A., & Jacobs, B. C. (2014). Diagnosis of Guillain-Barré syndrome and validation of Brighton criteria. Brain, 137(1), 33–43. https://doi.org/10.1093/brain/awt285

Hahn, A. F. (1998). Guillain-Barre syndrome. Lancet, 352(9128), 635–641. https://doi.org/10.1016/S0140-6736(97)12308-X

Hochman, B., Nahas F.X., Filho R.S.O., Ferreira L.M.F. Desenhos de pesquisa. Acta Cirúrgica Brasileira. 2005; 20 (2): 2-9

Honorato, M. M., Silva, F. L. L. da, Santos, A. C. V. dos, Silva, J. F. da, Cremaschi, R. M. de C., & Coelho, F. M. S. (2021). Covid-19: an Emerging Cause of Acute Cerebelitis in Adults? International Journal of Health Science, 1(3), 2–5. https://doi.org/10.22533/at.ed.1592120107

Jin, P. P., Sun, L. L., Ding, B. J., Qin, N., Zhou, B., Xia, F., Li, L., Liu-, L. J., Liu, X. D., Zhao, G., Wang, W., Deng, Y. C., & Hou, S. X. (2015). Human leukocyte antigen DQB1 (HLADQB1) polymorphisms and the risk for Guillain-Barré syndrome: A systematic review and meta-analysis. PLoS ONE, 10(7), 1–14. https://doi.org/10.1371/journal.pone.0131374

Kieseier, B. C., & Hartung, H. P. (2003). Therapeutic strategies in the Guillain-Barré syndrome. Seminars in Neurology, 23(2), 159–167. https://doi.org/10.1055/s-2003-41132

Li, X., Wang, Y., Wang, H., & Wang, Y. (2021). SARS-CoV-2-associated Guillain-Barré syndrome is a para-infectious disease. Qjm, 114(9), 625–635. https://doi.org/10.1093/qjmed/hcab157

McGann, J. P., & Bahuva, R. (2021). Diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in a Patient Presenting With Guillain-Barré Syndrome. Cureus, 13(10), 2–5. https://doi.org/10.7759/cureus.19147

Mendoza, D; Blancas, L y Gutiérrez, J. (2010). Artículo de revisión: Síndrome de Guillain - Barré. Alergia, Asma e Inmunología Pediátricas., 19(2), 56-63. https://www.medigraphic.com/pdfs/alergia/al-2010/al102c.pdf

Nunes, M. J. M., Carlos, J., Silva, S., Oliveira, C. De, Victor, G., & Medeiros, T. De. (2020). Alterações Neurológicas na Covid-19: uma Revisão Sistemática. Revista Neurociências, 28, 1–22. https://doi.org/10.34024/rnc.2020.v28.10949

Ousseiran, Z. H., Fares, Y., & Chamoun, W. T. (2021). Neurological manifestations of COVID-19: a systematic review and detailed comprehension. International Journal of Neuroscience, 0(0), 1–16. https://doi.org/10.1080/00207454.2021.1973000

Randhawa, J., Randhawa, H. S., & Toor, P. (2021). Pharyngeal-Cervical-Brachial Variant of Guillain-Barré Syndrome in a Patient of COVID-19 Infection. Cureus, 13(9), 2–9. https://doi.org/10.7759/cureus.17945

Silva, R. P. A. da. (2015). SÍNDROME DE GUILLAIN-BARRÉ Revisão retrospetiva da casuística dos casos hospitalizados no Centro Hospitalar do Porto. Monografia (Programa de mestrado integrado em medicina) -Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto, Porto. https://repositorio-aberto.up.pt/bitstream/10216/81939/2/37653.pdf

Toscano G, Palmerini F, Ravaglia S, Ruiz L, Invernizzi P, Cuzzoni MG, et al. Guillain-Barre´ syndrome associated with SARS-CoV-2. N Engl J Med 2020; 382:2574–6. https://www.nejm.org/doi/10.1056/NEJMc2009191

Umakanthan, S., Sahu, P., Ranade, A. V., Bukelo, M. M., Rao, J. S., Abrahao-Machado, L. F., Dahal, S., Kumar, H., & Kv, D. (2020). Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgraduate Medical Journal, 96(1142), 753–758. https://doi.org/10.1136/postgradmedj-2020-138234

Verboon, C., Van Doorn, P. A., & Jacobs, B. C. (2017). Treatment dilemmas in Guillain-Barré syndrome. Journal of Neurology, Neurosurgery and Psychiatry, 88(4), 346–352. https://doi.org/10.1136/jnnp-2016-314862

Vucic, S., Kiernan, M. C., & Cornblath, D. R. (2009). Guillain-Barré syndrome: An update. Journal of Clinical Neuroscience, 16(6), 733–741. https://doi.org/10.1016/j.jocn.2008.08.033

Walling, A. D., & Dickson, G. (2013). Guillain-Barré syndrome. American family physician, 87(3), 191–197.

WHO. (2021). Living Guidance for clinical management of COVID-19. World Health Organization, November, 63. https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-1

Willison, H. J., Jacobs, B. C., & van Doorn, P. A. (2016). Guillain-Barré syndrome. The Lancet, 388(10045), 717–727. https://doi.org/10.1016/S0140-6736(16)00339-1

Xavier, A. R., Silva, J. S., Almeida, J. P. C. L., Conceição, J. F. F., Lacerda, G. S., & Kanaan, S. (2020). COVID-19: manifestações clínicas e laboratoriais na infecção pelo novo coronavírus. Jornal Brasileiro de Patologia e Medicina Laboratorial, 56(5), 1–9.

Yüce, M., Filiztekin, E., & Özkaya, K. G. (2021). COVID-19 diagnosis —A review of current methods. Biosensors and Bioelectronics, 172, 112752. https://doi.org/10.1016/J.BIOS.2020.112752

Published

22/11/2022

How to Cite

SOUSA, E. J. S. de; NAVARRO, E. A. M. .; HONORATO, M. M. .; CREMASCHI, R. C. .; COELHO, F. M. S. . Characterization of post-COVID-19 Guillain-Barré syndrome in a private clinic in the inner Amazon – case series report . Research, Society and Development, [S. l.], v. 11, n. 15, p. e443111537532, 2022. DOI: 10.33448/rsd-v11i15.37532. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/37532. Acesso em: 31 jan. 2023.

Issue

Section

Health Sciences