Link Between COVID-19 and Guillain-Barrè Syndrome
Studies and case reports are emerging showing a link between COVID-19 and Guillain-Barrè syndrome. People with severe cases of the virus may develop Guillain-Barrè, a serious nervous system disorder. (1)
Guillain-Barre syndrome is a rare disorder. It causes the immune system to attack the nerves. For people who develop it, early symptoms include tingling and weakness in the extremities. It can become increasingly serious, even resulting in total paralysis. (2)
“Guillain-Barre syndrome is a well-known condition in which one’s immune system targets peripheral nerves as foreign and attacks them, resulting in the cardinal features of the disease,” Dr. Anthony Geraci told WebMD. Geraci is the director of neuromuscular medicine at Northwell Health in Great Neck, N.Y. (1)
Guillain-Barrè Syndrome
There is not a cure for Guillain-Barrè syndrome. However, there are treatments that can alleviate its symptoms and abbreviate how long a patient has to endure the illness. Many people recover from the nervous system disorder, although they may have lingering symptoms, like fatigue, numbness, and weakness. (2)
Guillain-Barrè often develops after a patient has contracted a serious case of a virus or other infectious disease. It usually occurs after a respiratory or digestive tract infection, so it’s not altogether surprising that there is a link to COVID-19. (1, 2)
Symptoms of the nervous system disorder include: (2)
- tingling and prickling in the fingers, wrists, toes, or ankles
- weakness beginning in the legs and spreading to the upper body
- walking unsteadily or being unable to walk
- being unable to climb the stairs
- eye and facial movements become difficult, including talking, chewing, and swallowing
- aches, pain, and cramps that might get worse at night
- accelerated heart rate
- challenging to control the bladder or to use the bowels
- blood pressure is low or high
- difficulty breathing
It is possible for these symptoms to worsen rapidly, which could require hospitalization. Patients with Guillain-Barrè should seek emergency medical attention if they are having difficulty breathing or swallowing or if they have quickly expanding tingling or weakness. (2)
Guillain-Barrè in Italian COVID-19 Patients
Case studies following a 65-year-old man and a 61-year-old woman who developed symptoms of Guillain-Barrè syndrome were published in early and mid-April 2020. A study, published in the New England Journal of Medicine on April 17, 2020, examined five COVID-19 patients who exhibited symptoms of the nervous system disorder in Pavia, Italy. (3, 4, 5)
According to the study, 1,200 patients were treated for COVID-19 by three hospitals in Pavia between February 28 and March 21. Doctors noticed five patients who showed symptoms of Guillain-Barrè. (1, 5)
The researchers observed that Guillain-Barrè symptoms appeared between five and 10 days after the emergence of COVID-19 symptoms. The five patients were treated with immune globulin therapy for the purpose of improving the immune response to the virus. One patient was also treated with the blood plasma of a survivor of COVID-19 to introduce antibodies to fight the virus. (1, 5)
The patients’ levels of recovery varied greatly. After a month of treatment, one patient was discharged and could walk independently. Two patients were still in the intensive care unit (ICU) on ventilators. And the last two were experiencing flaccid paraplegia with minimal upper-limb movement. They were both receiving physical therapy. (1, 5)
Syndrome Remains Rare
The study only found five out of 1,200 COVID-19 patients in Pavia, Italy to have symptoms of Guillain-Barrè. So the syndrome is still rare. But it can also be difficult to tell if COVID-19 patients in the ICU demonstrate symptoms of the nervous system disorder, as many are sedated and on mechanical ventilators. (1)
“In those cases, weakness and sensory loss can be very difficult to identify if they are not awake, moving their limbs, or able to tell you what they are experiencing,” Dr. Sami Saba, a neurologist at Lenox Hill Hospital in New York City, told WebMD. (1)
“However,” Saba continued, “since Guillain-Barre can affect the muscles that help us breathe, it will be very important to consider the diagnosis in those who have trouble coming off the ventilator, especially if their lung function looks to be recovering.” (1)
Doctors will need to use several tests to confirm a diagnosis of the nervous system disorder. Knowledge of this possible link between the syndrome and COVID-19 could be helpful for patients who are struggling to improve, even if chest imaging suggests that they should be. (1)
