Various COVID-19 Vaccines linked to Guillian- Barre Syndrome

There has been an increasing number of COVID-19 vaccine-related Guillain-Barre syndrome (GBS) following both messenger-RNA vaccine and adenovirus-vectored types causing public concern and the necessity to inform physicians about the variations of its presentations given its life-threatening consequences.

Guillain-Barré syndrome (GBS) is an immune-mediated polyradiculoneuropathy that is usually preceded commonly by infections such as Campylobacter jejuni, Mycoplasma pneumonia, the alphavirus chikungunya, the flaviviruses and viral outbreaks (Zika virus). Moreover, it has been linked to vaccination such as the influenza vaccine. With the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the association of GBS has been increasingly reported worldwide.

More recently, COVID-19 vaccine-related GBS has been described for both messenger-RNA vaccine and adenovirus-vectored types in a few cases. Although it is relatively uncommon, identifying the clinical presentations and the outcome of GBS following different COVID-19 vaccinations among different populations is essential, given the life-threatening consequences.

Researchers from Egypt report a case series of six males and one female with ages ranging from 29 to 59 years who presented with variable GBS manifestations from December 2021 to February 2022. Three patients received the AstraZeneca vaccine, two received the Pfizer vaccine, one received the Sinopharm and one received Janssen vaccine. Latency ranged from 5 to 60 days and cases achieved either partial or complete improvement after plasmapheresis. Although the outcome was favorable, partial recovery only was achieved.

In these aforementioned cases, GBS occurred following the vaccination. The authors suggest that vaccinations lead to producing T cells and antibodies and this could cross-react with the nerve roots structures. They say that a sharp watch should be kept for the variable presentations of GBS following different COVID-19 vaccination.

Attention drawn to such can lead to early identification and appropriate management, which in turn can lead to better outcomes.Reference: Shalash, A., Belal, N., Zaki, A.S. et al. Guillain–Barré syndrome following different COVID-19 vaccines: a case series. Egypt J Neurol Psychiatry Neurosurg 58, 153 (2022).

DOI: https://doi.org/10.1186/s41983-022-00582-7