Study shows more cases of GBS among those infected with COVID-19

By Joymala Bagchi
New Delhi [India], July 24 : A study on Guillain-Barre syndrome (GBS) conducted to understand the clinical profiles and outcome of GBS in COVID-19 from Maharashtra has shown more cases of parainfectious GBS in the setting of COVID-19.
The study was conducted by 15 major hospitals in Maharashtra dealing with GBS.
It found that "GBS in COVID occurs as both parainfectious and postinfectious GBS. Parainfectious needs more rigorous monitoring and may benefit from covid 19 specific treatment. Routine screening for Sarcov 2 should be implemented in patients with GBS in the view of the ongoing pandemic."
The study was observed within a period of nine to ten months starting from March 2020 on 42 patients with COVID-19 GBS.
The mean age was 59 years (of the range, 24--85 years) of which 73.8 per cent were men. GBS was the presenting symptom in 33 per cent while six of them remained asymptomatic. The interval between COVID-19 and GBS was 14 days with a minimum of 1 and a maximum of 40 days.
Importantly, 33.3 per cent of patients required a ventilator, with nine deaths while the observational study was on.
Dr Pradyumna Oak, Co-author of the study and Director and Head of Neurology, Nanavati Max Super Speciality Hospital said, "The study has proved an integral co-relation between COVID-19 and GBS, a rare neurological condition that forces the body's immune system to attack the nervous system, causing potential paralysis. We have found that despite its rarity, COVID-19 appears to be one of the viral infections which causes GBS. Though the prognosis of GBS is extremely good in most patients, we suggest that all COVID-19 should be actively screened by a neurologist to detect early signs of GBS for timely care."
Also a contributor to the study, Dr Prashant Makhija, Neurologist, Wockhardt Hospital, Mumbai Central said, "GBS is a rare disabling, potentially life-threatening neurological disorder wherein our immune system starts attacking nerves of the extremities. The trigger for this is usually a viral infection. The incidence of this illness is around 1 in 1lakh but we are observing a surge in GBS patients following Covid infection."
"Patients usually present with rapidly progressive weakness of the limbs which in up to 10-20 per cent of patients may affect breathing and these patients may require ventilator support. Treatment involves the administration of intravenous immunoglobulin or plasma exchange. Recovery depends on the severity of the deficits with some patients improving in few weeks while others may take up to 3-6 months," the doctor further said.
GBS was designated as coronavirus disease 2019 (COVID-19) by the WHO in February 2020.
GBS has also been reported with previous outbreaks of viruses such as Zika virus, MERS, West Nile virus, HIN1, Swine flu, and Chikungunya.
"Overall, the clinical presentation, nerve conduction studies, CSF studies were consistent with the typical non-COVID-19 GBS. In addition, for the postinfectious GBS we observed more cases of parainfectious GBS in the setting of COVID-19," the study concluded.