Pittsburgh doctors found a potential connection between covid-19 and the onset of the autoimmune disorder Guillain-Barré Syndrome, according to a case study from Allegheny General Hospital.
The neurologists, among the first in the country to document this link, published findings in the June issue of the Journal of Clinical Neuromuscular Disease.
Covid-19 creates immune-mediated processes and GBS is an immune-mediated disorder, according to a case study published in the Journal of Clinical Neuroscience in April.
“The increase of inflammation and inflammatory cells caused by (covid-19) may trigger an irregular immune response that leads to the hallmark symptoms of this neurological disorder,” Dr. Sandeep Rana, an AGH neurologist and lead author of the case study, said in a statement.
AGH is part of the Allegheny Health Network.
GBS occurs when a person’s immune system damages the nerves, causing muscle weakness and sometimes paralysis, according to the Centers for Disease Control and Prevention. GBS begins with tingling sensations that start in the feet and legs and spread to the upper body and arms, according to the Mayo Clinic.
“The most frequent type of trigger (for GBS) is an infection, either viral or bacterial,” said Dr. Justin McArthur, director of neurology at Johns Hopkins Medicine and president of the American Neurological Association.
McArthur, 64, of Baltimore, cited swine flu, mononucleosis and Zika virus as examples.
In other words, GBS can be contracted after a person is infected with covid-19, a virus that affects the respiratory system.
“GBS can significantly affect the respiratory system and other vital organs being pushed into overdrive during a covid-19 response,” Rana said.
According to McArthur, the name “Guillain-Barré” comes from two physicians in Europe who described the symptoms of the disorder in the early 20th century during World War I.
The GBS case in Pittsburgh involved a 54-year-old man who had symptoms of a severe respiratory infection.
He was brought to AGH following limb weakness and numbness as well as areflexia, which is when muscles don’t respond to stimuli. He was diagnosed positive for covid-19 at the hospital.
The man was found to have profound weakness in his legs, moderate weakness in his arms and facial muscles and minor weaknesses in muscles that control eye movement, according to the case study.
“The electrical abnormalities of this patient were consistent with (a) demyelinating form of GBS,” Rana said.
Similar cases found by clinicians at three northern Italy hospitals in April were published in the New England Journal of Medicine. Additionally, researchers in Wuhan, China, published reports in The Lancet indicating a potential connection.
This link is similar to a connection that neurologists like Rana have seen before.
“It’s not completely surprising that a covid-19 diagnosis may lead to a patient developing GBS,” Rana said. “In fact, similar connections were made during the 2016 Zika virus outbreak.”
McArthur agreed that the findings were not surprising, given the history of GBS.
“(The findings don’t) open a new line of research in my opinion, but that doesn’t mean it’s not important to report on,” he said. “Fortunately, (GBS) doesn’t seem to be a very common manifestation of covid-19. Otherwise, we would’ve had thousands of cases.”
Johns Hopkins is the center for studying GBS and the location of one of the first studies showing that the “plasma exchange” treatment was effective for the neurological disorder in the late 1980s or early ’90s.
Rana believes further investigation of the potential connection between covid-19 and the onset of GBS is crucial.
“As we continue to observe covid-19 and its manifestations, we’re anticipating that the rate of GBS incidents may be higher than initially expected,” Rana said.
Megan Swift is a Tribune-Review staff writer. You can contact Megan at 724-850-2810, [email protected] or via Twitter .
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