COVID-19-associated Guillain-Barré syndrome: The early pandemic experience. James B Caress 1 , Ryan J Castoro 1 , Zachary Simmons 2 , Stephen N Scelsa 3 , Richard A Lewis 4 , Aditi Ahlawat 5 , Pushpa Narayanaswami 5

COVID-19-associated Guillain-Barré syndrome: The early pandemic experience James B Caress 1 , Ryan J Castoro 1 , Zachary Simmons 2 , Stephen N Scelsa 3 , Richard A Lewis 4 , Aditi Ahlawat 5 , Pushpa Narayanaswami 5

Free PMC article Abstract Guillain-Barré syndrome (GBS) is an inflammatory polyradiculoneuropathy associated with numerous viral infections. Recently, there have been many case reports describing the association between coronavirus disease-2019 (COVID-19) and GBS, but much remains unknown about the strength of the association and the features of GBS in this setting. We reviewed 37 published cases of GBS associated with COVID-19 to summarize this information for clinicians and to determine whether a specific clinical or electrodiagnostic (EDx) pattern is emerging. The mean age (59 years), gender (65% male), and COVID-19 features appeared to reflect those of hospitalized COVID-19 patients early in the pandemic. The mean time from COVID-19 symptoms to GBS symptoms was 11 days. The clinical presentation and severity of these GBS cases was similar to those with non-COVID-19 GBS. The EDx pattern was considered demyelinating in approximately half of the cases. Cerebrospinal fluid, when assessed, demonstrated albuminocytologic dissociation in 76% of patients and was negative for severe acute respiratory distress syndrome-coronavirus-2 (SARS-CoV-2) in all cases. Serum antiganglioside antibodies were absent in 15 of 17 patients tested. Most patients were treated with a single course of intravenous immunoglobulin, and improvement was noted within 8 weeks in most cases. GBS-associated COVID-19 appears to be an uncommon condition with similar clinical and EDx patterns to GBS before the pandemic. Future studies should compare patients with COVID-19-associated GBS to those with contemporaneous non-COVID-19 GBS and determine whether the incidence of GBS is elevated in those with COVID-19. Keywords: Guillain-Barre syndrome; SARS-CoV- REFERENCES Mao L, Jin H, Wang M, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683-690. https://doi.org/10.1001/jamaneurol.2020.1127. 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