Epidemiological and cohort study finds no association between COVID-19 and Guillain-Barré syndrome

  1. S Keddie
  2. J Pakpoor
  3. C Mousele
  4. M Pipis
  5. PM Machado
  6. M Foster
  7. CJ Record
  8. YS Keh
  9. J Fehmi
  10. RW Paterson
  11. V Bharambe
  12. LM Clayton
  13. C Allen
  14. O Price
  15. J Wall
  16. A Kiss-Csenki
  17. DP Rathnasabapathi
  18. R Geraldes
  19. T Yermakova
  20. J King-Robson
  21. M Zosmer
  22. S Rajakulendran
  23. R Nortley
  24. CR Marshall
  25. E Newman
  26. N Nirmalananthan
  27. G Kumar
  28. AA Pinto
  29. J Holt
  30. TM Lavin
  31. K Brennan
  32. M Zandi
  33. DL Jayaseelan
  34. J Pritchard
  35. RDM Hadden
  36. H Manji
  37. HJ Willison
  38. S Rinaldi
  39. AS Carr
  40. MP Lunn
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Abstract

Background

Reports of Guillain-Barré Syndrome (GBS) have emerged during the Coronavirus Disease 2019 (COVID-19) pandemic. This epidemiological and cohort study sought to investigate any causative association between COVID-19 infection and GBS.

Methods

The epidemiology of GBS cases reported via the UK National Immunoglobulin Database were studied from 2016-2019 and compared to cases reported during the COVID-19 pandemic. For the cohort study, members of the British Peripheral Nerve Society reported all cases of GBS during the pandemic. The clinical features, investigation findings and outcomes of COVID-19 (definite or probable) and non-COVID-19 associated GBS cases were compared.

Results

The UK GBS incidence from 2016-2019 was 1.65-1.88 per 100,000 people per year. GBS and COVID-19 incidence varied between regions and did not correlate (r = 0.06, 95% CI −0.56 to 0.63, p=0.86). GBS incidence fell between March and May 2020 compared to the same months of 2016-2019. Forty-seven GBS cases were included in the cohort study (13 definite, 12 probable COVID-19 and 22 non-COVID-19). There were no significant differences in the pattern of weakness, time to nadir, neurophysiology, CSF findings or outcome. Intubation was more frequent in the COVID-19+ve cohort (7/13, 54% vs 5/22, 23% in COVID negative) thought to be related directly to COVID-19 pulmonary involvement.

Conclusions

This study finds no epidemiological or phenotypic clues of SARS-CoV-2 being causative of GBS. GBS incidence has fallen during the pandemic which may be the influence of lockdown measures reducing transmission of GBS inducing pathogens such as Campylobacter jejuni and respiratory viruses.

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