Can a COVID Infection Trigger GBS?

November 1, 2021

Guillain-Barré Syndrome (GBS) is an autoimmune neurological condition that results in damaged nerve cells. Cases of GBS have been verified by the FDA as a rare side effect to certain vaccines, including Johnson & Johnson’s COVID-19 vaccine. GBS has also been known to develop after certain respiratory or gastrointestinal viral infections and may be triggered by a COVID-19 infection. 

The International GBS Outcome Study is an ongoing prospective observational cohort study with GBS patients. Data from January 30 – May 30, 2020, was collected and analyzed to investigate the connection between GBS and COVID-19 infections. 49 GBS patients were included and 48 completed questionnaires assessing clinical suspicion for SARS-CoV-2. Of this cohort, 8 patients (16%) had a confirmed previous SARS-CoV-2 infection, and 3 patients (6%) had a probable SARS-CoV-2 infection.

The median age of patients within the cohort was 56 years; the median age of patients with a confirmed or probable COVID-19 infection was 63 years. 73% of GBS patients with a COVID-19 infection presented increased inflammatory markers; 64% had facial palsy. 

Overall, 22% of GBS patients had a preceding COVID-19 infection. It was not determined whether recovery was more difficult for the patients versus other GBS patients, especially when factoring severity of COVID-19 infection. Researchers emphasized that analysis from the first four months of the pandemic did not show an increase in GBS cases compared to previous years. Therefore, while Covid-19 infections may trigger the development of GBS, a stronger causal relationship has yet to be determined. “Should SARS-CoV-2 indeed be able to trigger GBS, our data are consistent with a post-infectious disease mechanism rather than direct viral invasion, as the time between the onset of SARS-CoV-2 symptoms and GBS ranged from 2 to 3.5 weeks.”