COVID-19 and Guillain–Barré Syndrome

On April 17, 2020, the online New England Journal of Medicine published the correspondence Guillain–Barré Syndrome Associated with SARS-CoV-2.  The paper was authored by a team of Italian physicians and describes a previously unreported potential association between COVID-19 and Guillain–Barré Syndrome, an autoimmune disease associated with ascending paresthesia and paralysis of the lower extremities.

The team reported that, of an estimated 1000 to 1200 patients with COVID-19 admitted to three hospitals in Northern Italy from February 28 through March 21, 2020, five patients developed Guillain–Barré syndrome within 10 days of the onset of COVID-19 symptoms.  In four of these patients, lower-limb weakness and paresthesia were among the first symptoms noted.

Although viral infections have long been considered a possible trigger for Guillain–Barré syndrome, this is believed to be the first report indicating a potential association between the SARS-CoV-2, the virus that causes of COVID-19, and Guillain–Barré syndrome.  Other viruses associated with Guillain–Barré Syndrome include Zika virus, Epstein–Barr virus, cytomegalovirus, human immunodeficiency virus (HIV), influenza virus and the coronavirus responsible for Middle East Respiratory Syndrome (MERS).

On a personal note, I would like to take this opportunity to wish all of you the best of luck during these trying times.  These are truly dark days, but they will pass.

To the heroes among us who have put their own health at risk by treating patients with COVID-19, thank you for your good work, your bravery and your courage.  You make us all very proud and exceedingly grateful.