Does SARS-CoV-2 infection trigger Guillain-Barré syndrome?

Some patients with SARS-CoV-2 may subsequently develop Guillain-Barré syndrome (GBS), although this occurrence is infrequent and a causative link cannot be determined, as reported in a study.

The analysis included 49 GBS patients who were enrolled within 2 weeks of weakness onset across selected countries, including China, the Netherlands, Switzerland, Japan, Denmark, and France, among others.

Of the patients, eight (16 percent) had a confirmed SARS-CoV-2 infection while three (6 percent) had a probable SARS-CoV-2 infection. Two of these 11 patients showed serological evidence of a recent Campylobacter jejuni infection, while the remaining 11 had no serological evidence of other recent infections that could have prompted GBS.

Most of the patients with a confirmed or probable SARS-CoV-2 infection had a sensorimotor variant (73 percent) and experienced facial palsy (64 percent). A demyelination form of GBS was seen in all eight infected patients who underwent electrophysiological examination.

Neurological symptoms occurred a median of 16 days (interquartile range 12–22) after the onset of SARS-CoV-2 infection. GBS patients with preceding SARS-CoV-2 infection exhibited neurological features that were similar to those previously described in other postviral GBS patients.

The frequency of a preceding SARS-CoV-2 infection in the present cohort was 22 percent, which was higher than the estimates of the contemporaneous background prevalence of SARS-CoV-2. The discrepancy might be attributed to recruitment bias during the pandemic but could also indicate that GBS might rarely follow a recent SARS-CoV-2 infection.

More studies are needed to determine whether there is a causative association between SARS-CoV-2 and GBS.