With more than 55 million cases and over 1.3 million deaths worldwide, coronavirus is among the deadliest pandemics rapidly spreading across the world. While Moderna and Pfizer’s vaccine candidate results ignited hope in people, there are other worries which continue to linger. Of all, some syndromes which developed in patients infected by COVID-19 remain a cause of concern and one of these is Guillain-Barre syndrome which has been associated with the coronavirus infection.
Recently over 24 cases of Guillain-Barre syndrome were reported in Mumbai compelling City neurologists to come together to conduct a study on the neurological complication. These 24 patients, who were infected with coronavirus, developed paralysis due to this autoimmune disorder.
Guillain-Barre syndrome is “an inflammatory disorder of the peripheral nerves outside the brain and spinal cord” caused by bacteria or viral infection. The very rare autoimmune disorder occurs when the immune system accidentally starts attacking the peripheral nervous system while trying to kill the coronavirus. Attacking the peripheral nervous system, a network of nerves that lead from the brain and spinal cord to different parts of the body can affect limb functions hence leading a person from normal to paralysis within just 2 to 3 days. While the paralysis is temporary in its early stage, it can become temporary and even life-threatening if not treated in time. In simple words, Guillain-Barre syndrome is a life-threatening autoimmune disorder which causes paralysis.
GBS is characterized by the rapid onset of numbness, weakness, and often paralysis of the legs, arms, breathing muscles, and face. First symptoms of the syndrome are tingling or itching sensation in the skin followed by muscle pain, weakness and numbness. Nerves of hands and legs are affected due to GBS leading to sudden paralysis. Breathing may be affected in severe cases and ventilator support may be required. The symptoms of the syndrome begin to show within 5 to 10 days of onset of COVID-19 symptoms, as per and Italian group of researchers. The neurologic symptoms tend to get worse within the next 2 days and all four limbs get weakened or paralyzed.
While there is no known cure for GBS yet, doctors say treatment can help ease symptoms and control damage. Even recovered patients are recommended to get regular follow-ups in order to be able to identify any symptoms. Some of the tests that can help diagnose GBS include GBS MRI of the brain, cerebrospinal fluid examination, chest scans, as well as tests for blood inflammatory markers and nerve conduction velocity.
The first case of GBS related to COVID-19 was reported in the US in the month of June and India has been reporting these syndrome cases since August. The Indiana University reported country’s first pediatric case of GBS on November 9 in an eight-year-old boy who had tested positive for Covid-19.
However, there has been an increase in the number of cases over the past three months. A recent study published in the Journal of Neurology, Neurosurgery and Psychiatry also found higher-than-expected numbers of GBS cases in northern Italy during COVID-19 pandemic. The study also noted high frequency of GBS among Covid-19 patients.
In Mumbai, neurologists reportedly received around 7 reported GBS cases among Covid-19 patients and the number increased to 24 by September-end. Meanwhile, a 47-year-old man who had tested COVID-positive and later was diagnosed with GBS was successfully treated at a facility in Delhi in first week of November. The syndrome is not just reported in adults but also in children and even patients recovered from coronavirus were diagnosed with GBS weeks later.
A multi-doctor study and registry in Mumbai is underway and slated to be finished in three weeks. The study is collecting case studies of Covid-19 patients with GBS and mapping their symptoms. Several neurologists in Mumbai are part of it. “GBS can leave behind permanent neurological damage. Most will completely recover but some may have paralysis in limb and weakness in body for a longer period,” Agrawal says.
This is not the first time when GBS cases spiked during a pandemic as previously patients of Middle East Respiratory Syndrome showed GBS symptoms, as did those infected with Zika, HIV, Herpes virus and Campylobacter jejuni.