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No association between COVID-19 and Guillain-Barré syndrome

Neuroscientists at UCL and UCLH have found no significant association between Covid-19 and the potentially paralysing and sometimes fatal neurological condition Guillain-Barré syndrome.

Researchers say the findings, published in the journal Brain, should provide the public with reassurance, as the UK’s national coronavirus vaccination programme is rolled out.

Guillain-Barré syndrome (GBS) is a rare but serious autoimmune condition that attacks the peripheral nervous system, typically affecting the feet, hands and limbs, causing numbness, weakness and pain. While its exact cause is unknown, GBS often occurs after a gastroenteritis infection called Camplylobacter, with the immune system mistakenly attacking nerves rather than germs.

GBS is usually reversible, however in severe cases it can cause prolonged paralysis involving breathing muscles, require ventilator support and sometimes leave permanent neurological deficits. Early recognition by expert neurologists is key to proper treatment.

More cases of GBS were associated with the Zika virus outbreaks in Latin America (2016 and 2020) than expected by chance alone; and concerns have been raised in GBS research reports that a similar link may potentially exist between COVID-19 infection and GBS too.

In this study, researchers sought to investigate any causative association between Covid-19 infection and GBS.

The team assessed the number of GBS treatments reported to the NHS England National Immunoglobulin Database between 2016 and 2019. This was compared to the number of cases reported during the pandemic in the first half of 2020.

The annual incidence of GBS treated in UK hospitals between 2016 and 2019 was 1.65-1.88 per 100,000 individuals. Incidences of GBS fell 40-50% between March and May 2020 when compared to the same months of 2016-2019. This new finding contradicts that of other smaller and less extensive international studies.  

First author, Dr Stephen Keddie, of UCL and UCLH, said: “The possibility of SARS-CoV-2 driving a global spike in GBS has been eagerly monitored with a number of published small case series already asserting a causal link. However, a surge in GBS cases after the SARS-CoV-2 pandemic has not been detected as happened in the Zika virus pandemic.

“Our epidemiological study shows there was no increased incidence in GBS during the first wave of COVID-19; rather, there was a decrease and therefore no causal link of COVID-19 to GBS can be made.”

Separately in this study the research team also tried to establish if there was any genetic or protein structure in SARS-CoV-2, the virus that causes COVID-19, which could trigger an immune response causing GBS. No credible link was found with SARS-CoV-2.