{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:12:37Z","timestamp":1772169157473,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.15987.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T00:00:00Z","timestamp":1600646400000}}],"reference-count":17,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T00:00:00Z","timestamp":1600646400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["214185"],"award-info":[{"award-number":["214185"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    Guillain-Barre Syndrome (GBS) is a neurological autoimmune disease that can lead to respiratory failure and death. Whether COVID-19 patients are at high risk of GBS is unknown. Through a systematic review of case reports, we aimed to summarize the main features of patients with GBS and COVID-19.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    Without any restrictions, we searched MEDLINE, Embase, Global Health, Scopus, Web of Science and MedXriv (April 23 rd, 2020). Two reviewers screened and studied titles, abstracts and reports. We extracted information to characterize sociodemographic variables, clinical presentation, laboratory results, treatments and outcomes.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    Eight reports (n=12 patients) of GBS and COVID-19 were identified; one was a Miller Fisher case. The age ranged between 23 and 77 years, and there were more men (9\/102). GBS symptoms started between 5 and 24 days after those of COVID-19. The protein levels in cerebrospinal fluid samples ranged between 40 and 193 mg\/dl. None of the cerebrospinal fluid samples tested positive for COVID-19. Six patients debuted with ascendant weakness and three with facial weakness. Five patients had favourable evolution, four remained with relevant symptoms or required critical care and one died; the Miller Fisher case had successful resolution.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions:<\/ns4:bold>\n                    GBS is emerging as a disease that may appear in COVID-19 patients. Although limited, preliminary evidence appears to suggest that GBS occurs after COVID-19 onset. Practitioners and investigators should have GBS in mind as they look after COVID-19 patients and conduct research on novel aspects of COVID-19. Comparison with GBS patients in the context of another viral outbreak (Zika), revealed similarities and differences that deserves further scrutiny and epidemiological studies.\n                  <\/ns4:p>","DOI":"10.12688\/wellcomeopenres.15987.2","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T13:21:58Z","timestamp":1600694518000},"page":"107","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":32,"title":["COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports"],"prefix":"10.12688","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2090-1856","authenticated-orcid":false,"given":"Rodrigo M.","family":"Carrillo-Larco","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Altez-Fernandez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina","family":"Ravaglia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0306-4774","authenticated-orcid":false,"given":"Joaqu\u00edn A.","family":"Vizcarra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2020,9,21]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"233-235","DOI":"10.1016\/j.jocn.2020.04.062","article-title":"Guillain Barre syndrome associated with COVID-19 infection: A case report.","volume":"76","author":"Z Sedaghat","year":"2020","journal-title":"J Clin Neurosci."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"2574-2576","DOI":"10.1056\/NEJMc2009191","article-title":"Guillain-Barr\u00e9 Syndrome Associated with SARS-CoV-2.","volume":"382","author":"G Toscano","year":"2020","journal-title":"N Engl J Med."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"e00771","DOI":"10.1016\/j.idcr.2020.e00771","article-title":"Guillain-Barr\u00e9 Syndrome associated with SARS-CoV-2 infection.","author":"A Virani","year":"2020","journal-title":"IDCases."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"383-4","DOI":"10.1016\/S1474-4422(20)30109-5","article-title":"Guillain-Barr\u00e9 syndrome associated with SARS-CoV-2 infection: causality or coincidence?","volume":"19","author":"H Zhao","year":"2020","journal-title":"Lancet Neurol."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"e601-e605","DOI":"10.1212\/WNL.0000000000009619","article-title":"Miller Fisher Syndrome and polyneuritis cranialis in COVID-19.","volume":"95","author":"C Guti\u00e9rrez-Ortiz","year":"2020","journal-title":"Neurology."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"1877-1879","DOI":"10.1007\/s00415-020-09849-6","article-title":"Guillain-Barr\u00e9 syndrome following COVID-19: new infection, old complication?","volume":"267","author":"M Padroni","year":"2020","journal-title":"J Neurol."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"132-42","DOI":"10.1111\/tmi.13181","article-title":"Systematic review of factors associated with the development of Guillain-Barr\u00e9 syndrome 2007-2017: what has changed?","volume":"24","author":"V Wachira","year":"2019","journal-title":"Trop Med Int Health."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"e0007622","DOI":"10.1371\/journal.pntd.0007622","article-title":"Incidence of Guillain-Barr\u00e9 Syndrome (GBS) in Latin America and the Caribbean before and during the 2015-2016 Zika virus epidemic: A systematic review and meta-analysis.","volume":"13","author":"A Capasso","year":"2019","journal-title":"PLoS Negl Trop Dis."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"e032275","DOI":"10.1136\/bmjopen-2019-032275","article-title":"Health outcomes associated with Zika virus infection in humans: a systematic review of systematic reviews.","volume":"9","author":"R Ximenes","year":"2019","journal-title":"BMJ Open."},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"671-83","DOI":"10.1038\/s41582-019-0250-9","article-title":"Diagnosis and management of Guillain-Barr\u00e9 syndrome in ten steps.","volume":"15","author":"S Leonhard","year":"2019","journal-title":"Nat Rev Neurol."},{"key":"ref-11","article-title":"COVID-19 and Guillain-Barre Syndrome: A systematic review of case reports.","author":"C Rodrigo","year":"2020","journal-title":"figshare."},{"key":"ref-12","doi-asserted-by":"publisher","first-page":"20060251","DOI":"10.1101\/2020.04.17.20060251","article-title":"Two patients with acute meningo-encephalitis concomitant to SARS-CoV-2 infection.","author":"R Bernard-Valnet","year":"2020","journal-title":"medRxiv."},{"key":"ref-13","doi-asserted-by":"publisher","first-page":"e741","DOI":"10.1212\/NXI.0000000000000741","article-title":"Guillain-Barre syndrome related to COVID-19 infection.","volume":"7","author":"P Alberti","year":"2020","journal-title":"Neurol Neuroimmunol Neuroinflamm."},{"key":"ref-14","doi-asserted-by":"publisher","first-page":"516-518","DOI":"10.1016\/j.neurol.2020.04.003","article-title":"COVID-19 may induce Guillain-Barre syndrome.","volume":"176","author":"J Camdessanche","year":"2020","journal-title":"Rev Neurol (Paris)."},{"key":"ref-15","doi-asserted-by":"publisher","first-page":"1089-97","DOI":"10.1001\/jamaneurol.2018.1058","article-title":"Clinical Features of Guillain-Barr\u00e9 Syndrome With vs Without Zika Virus Infection, Puerto Rico, 2016.","volume":"75","author":"E Dirlikov","year":"2018","journal-title":"JAMA Neurol."},{"key":"ref-16","doi-asserted-by":"publisher","first-page":"1513-23","DOI":"10.1056\/NEJMoa1605564","article-title":"Guillain-Barr\u00e9 Syndrome Associated with Zika Virus Infection in Colombia.","volume":"375","author":"B Parra","year":"2016","journal-title":"N Engl J Med."},{"key":"ref-17","doi-asserted-by":"publisher","first-page":"72-81","DOI":"10.1007\/s12026-016-8816-8","article-title":"Guillain-Barr\u00e9 syndrome in Colombia: where do we stand now?","volume":"65","author":"M Mahecha","year":"2017","journal-title":"Immunol Res."}],"container-title":["Wellcome Open 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.17533.r38881, Hugh J Willison, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK, 25 Jun 2020, version 1, 1 approved, 1 not approved","URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-107\/v1#referee-response-38881","order":0,"name":"referee-response-38881","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.17955.r40538, Maria Regina Fernandes de Oliveira, Centre for Tropical Medicine, University of Bras\u00edlia, Brasilia, Brazil, 22 Sep 2020, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/5-107\/v2#referee-response-40538","order":1,"name":"referee-response-40538","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work is supported by Wellcome [214185; International Training Fellowship to RMC-L]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}