Evaluation of Patients with Guillain-Barré Syndrome After Covid-19 Infection

Abstract

Aim: Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy often triggered by infections. Since the emergence of COVID-19, neurological complications including GBS have been increasingly reported. However, data on the clinical and electrophysiological characteristics of COVID-19 related GBS remain limited. This study aimed to evaluate the demographic, clinical and electrophysiological features of patients diagnosed with GBS following COVID-19 infection. Methods: A retrospective analysis was conducted on 10 patients diagnosed with GBS within 30 days of confirmed COVID-19 infection at Sakarya University Training and Research Hospital between 2020 and 2022. Data on demographics, clinical presentation, electrophysiological findings, cerebrospinal fluid (CSF) analysis, treatment and prognosis were collected. Results: The mean age was 57 years. The average interval between COVID-19 symptom onset and GBS manifestation was 14 days. Electrophysiologically, four patients had acute inflammatory demyelinating polyneuropathy, three had acute motor axonal neuropathy and three had acute motor sensory axonal polyneuropathy variants. Treatment with intravenous immunoglobulin was administered to all patients; four required additional plasmapheresis. Four patients were admitted to intensive care, and two required mechanical ventilation. On day 30, six patients had a Hughes Functional Grading Scale Score of ≤2, and two patients had died. Worse outcomes were associated with higher CSF protein levels and axonal subtypes. Conclusion: GBS may develop as a post-infectious complication of COVID-19, typically within 2–3 weeks. Although most patients responded well to treatment, axonal variants and elevated CSF protein levels were associated with worse prognosis. Further large-scale studies are needed to clarify this association.

Keywords

• COVID-19
• Polyneuropathy
• Hughes Functional Grading Scale

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