Abstract
Since December 2019, the world has been facing an outbreak of a new disease called coronavirus disease 2019 (COVID-19). The COVID-19 pandemic is caused by a novel beta-coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The SARS-CoV-2 infection mainly affects the respiratory system. Recently, there have been some reports of extra-respiratory symptoms such as neurological manifestations in COVID-19. According to the increasing reports of Guillain-Barré syndrome following COVID-19, we mainly focused on SARS-CoV-2 infection and Guillain-Barré syndrome in this review. We tried to explain the possibility of a relationship between SARS-CoV-2 infection and Guillain-Barré syndrome and potential pathogenic mechanisms based on current and past knowledge.
Highlights
Over the past two decades, coronaviruses have caused three epidemic diseases named the severe acute respiratory syndrome (SARS), the Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19) [1]
We mainly focused on SARS-CoV-2 infection and Guillain-Barré syndrome and tried to explain the potential pathogenic mechanisms based on current and past knowledge
The prevalence rate of neurological symptoms is estimated to be around 3.5 to 84% among COVID-19 patients, in most cases the SARS-CoV-2 ribonucleic acid (RNA) was not detected in the cerebrospinal fluid (CSF) [28, 30, 31]
Summary
Over the past two decades, coronaviruses have caused three epidemic diseases named the severe acute respiratory syndrome (SARS), the Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19) [1]. Neurological symptoms were reported in some COVID-19 cases, raising concerns about the potential of the SARS-CoV-2 to invade nerves and lead to neurological complications, both in Abbreviations: COVID-19, coronavirus disease 2019; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, SARS, severe acute respiratory syndrome; MERS, Middle East respiratory syndrome; RNA, ribonucleic acid; HCoV, Human coronavirus; ACE-2, angiotensin converting enzyme-2 receptor; BSG, basigin; NRP1, neuropilin-1; CNS, central nervous system; PNS, peripheral nervous system; AFP, acute flaccid paralysis; MS, multiple sclerosis; ADEM, acute demyelinating encephalomyelitis; GBS, Guillain-Barré syndrome; RT-PCR, reverse transcriptase PCR; PCR, polymerase chain reaction; CSF, cerebrospinal fluid; BBE, Bickerstaff’s encephalitis; CoVs, coronaviruses; IL, interleukin; TNF-a, tumor necrosis factor-alpha; CMV, cytomegalovirus; EBV, Epstein-Barr virus; arboviruses, arthropod-borne viruses; ZIKV, zika virus; HSP, heat shock proteins; IFN-g, interferon-g; MND, motor neuron diseases. The term “neuro-COVID” is used to describe these complications [28, 29]
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