Abstract
BackgroundAmidst growing concern about an increased risk of Guillain–Barré syndrome (GBS) following COVID-19 vaccination, clinical and electrodiagnostic features have not been fully characterized.MethodsWe retrospectively reviewed medical records of the patients diagnosed with GBS and its variants following COVID-19 vaccination at four referral hospitals during the period of the mass vaccination program in South Korea (February to October 2021).ResultsWe identified 13 patients with GBS and variants post COVID-19 vaccination: AstraZeneca vaccine (Vaxzevria) in 8, and Pfizer-BioNTech vaccine (Comirnaty) in 5. The mean time interval from vaccination to symptom onset was 15.6 days (range 4–30 days). Electrodiagnostic classification was demyelinating in 7, axonal in 4 and normal in 2 cases. Clinical manifestations were diverse with varying severity: classical GBS in 8 cases, paraparetic variant in 3, Miller-Fisher syndrome in 1 and acute cervicobrachial weakness in 1. Four patients developed respiratory failure, and 2 of them showed treatment-related fluctuations.ConclusionOur observations suggest that COVID-19 vaccines may be associated with GBS of distinctive clinical features characterized by severe quadriplegia, disproportionately frequent bilateral facial palsy or atypical incomplete variants. Continuous surveillance and further studies using robust study designs are warranted to fully assess the significance of the association.
Highlights
Guillain–Barré syndrome (GBS) is the most common cause of acute flaccid paralysis with an incidence of 0.81 to 1.91 cases per 100,000 person-years [1]
Despite a growing concern for an increased risk of GBS post-COVID-19 vaccination, the current literature is limited to several case reports and a study based on a passive reporting system that is subject to presumptive case definition and underreporting [4,5,6,7,8,9]
We identified 13 patients with GBS post COVID-19 vaccination (4 males, 9 females): 8 patients received the AstraZeneca vaccine (Vaxzevria) and 5 received the Pfizer-BioNTech vaccine (Comirnaty)
Summary
Guillain–Barré syndrome (GBS) is the most common cause of acute flaccid paralysis with an incidence of 0.81 to 1.91 cases per 100,000 person-years [1]. Despite a growing concern for an increased risk of GBS post-COVID-19 vaccination, the current literature is limited to several case reports and a study based on a passive reporting system that is subject to presumptive case definition and underreporting [4,5,6,7,8,9]. We undertook a review of 13 cases consecutively encountered at four referral centers during the period of mass vaccination in South Korea (February to October 2021) to investigate clinical and electrodiagnostic patterns of GBS following COVID-19 vaccination. Amidst growing concern about an increased risk of Guillain–Barré syndrome (GBS) following COVID-19 vaccination, clinical and electrodiagnostic features have not been fully characterized
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