{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T02:53:01Z","timestamp":1782874381169,"version":"3.54.5"},"reference-count":55,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005802","name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, Romania","doi-asserted-by":"publisher","award":["33PFE\/30.12.2021"],"award-info":[{"award-number":["33PFE\/30.12.2021"]}],"id":[{"id":"10.13039\/501100005802","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Research and Innovation within PNCDI III, Program 1\u2014Development of the National RD system","award":["33PFE\/30.12.2021"],"award-info":[{"award-number":["33PFE\/30.12.2021"]}]},{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, Romania, Department of Research and Grants","award":["33PFE\/30.12.2021"],"award-info":[{"award-number":["33PFE\/30.12.2021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: Guillain\u2013Barr\u00e9 syndrome (GBS)\u2014a rare condition characterized by acute-onset immune-mediated polyneuropathy\u2014has been registered as a neurological manifestation of COVID-19, suggesting a possible link between these two conditions. Methods: We report a case series of patients with COVID-19-related GBS hospitalized in the Neurology Department of Colentina Clinical Hospital, Bucharest, Romania, between March 2020 and March 2021. Several variables were analyzed, such as the mean interval between the onset of COVID-19 symptoms and neurological ones, clinical features, treatment course, and outcome. Further on, we conducted a thorough literature review based on the PubMed and ScienceDirect scientific databases. Results: A total of 9 COVID-19 patients developed symptoms of GBS, out of which in 7, it manifested as an acute inflammatory demyelinating polyneuropathy (AIDP). Five patients presented respiratory failure, 2 requiring mechanical ventilation. All patients received a course of intravenous immunoglobulins, 2 additionally requiring plasma exchange. Upon discharge, all but 1 patient (who had not regained the ability to walk) had a positive outcome, and 1 died during admission. In the literature review, we analyzed the published sources at the time of writing. Conclusions: A link between COVID-19 and GBS might be possible; therefore, increased vigilance is required in the early identification of these cases for prompt diagnosis and treatment. Some notable differences such as an earlier onset of GBS symptoms, higher respiratory dysfunction, and higher mortality rates in COVID-19 patients have been observed between the presentation of GBS in the context of COVID-19 and GBS of other causes.<\/jats:p>","DOI":"10.3390\/medicina58080977","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T01:42:13Z","timestamp":1658713333000},"page":"977","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["COVID-19 Associated Guillain\u2013Barr\u00e9 Syndrome: A Report of Nine New Cases and a Review of the Literature"],"prefix":"10.3390","volume":"58","author":[{"given":"Andreea Paula","family":"Ivan","sequence":"first","affiliation":[{"name":"Department of Neurology, Colentina Clinical Hospital, 020125 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Odajiu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Colentina Clinical Hospital, 020125 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4826-2598","authenticated-orcid":false,"given":"Bogdan Ovidiu","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Colentina Clinical Hospital, 020125 Bucharest, Romania"},{"name":"Department of Clinical Neurosciences, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Cell Biology, Neurosciences and Experimental Myology, \u201dVictor Babe\u0219\u201d National Institute of Pathology, 050096 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6862-5515","authenticated-orcid":false,"given":"Eugenia Irene","family":"Davidescu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Colentina Clinical Hospital, 020125 Bucharest, Romania"},{"name":"Department of Clinical Neurosciences, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"ref_1","unstructured":"(2021, October 30). World Health Organization\u2014WHO Coronavirus (COVID-19) Dashboard. Available online: https:\/\/covid19.who.int\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/JCMA.0000000000000463","article-title":"Clinical manifestation and disease progression in COVID-19 infection","volume":"84","author":"Tsai","year":"2020","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Salton, F., Confalonieri, P., Campisciano, G., Cifaldi, R., Rizzardi, C., Generali, D., Pozzan, R., Tavano, S., Bozzi, C., and Lapadula, G. (2022). Cytokine Profiles as Potential Prognostic and Therapeutic Markers in SARS-CoV-2-Induced ARDS. J. Clin. Med., 11.","DOI":"10.3390\/jcm11112951"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Baratella, E., Ruaro, B., Marrocchio, C., Starvaggi, N., Salton, F., Giudici, F., Quaia, E., Confalonieri, M., and Cova, M.A. (2021). Interstitial Lung Disease at High Resolution CT after SARS-CoV-2-Related Acute Respiratory Distress Syndrome According to Pulmonary Segmental Anatomy. J. Clin. Med., 10.","DOI":"10.3390\/jcm10173985"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Alqahtani, M., Abbas, M., Alqahtani, A., Alshahrani, M., Alkulib, A., Alelyani, M., Almarhaby, A., and Alsabaani, A. (2021). A Novel Computational Model for Detecting the Severity of Inflammation in Confirmed COVID-19 Patients Using Chest X-ray Images. Diagnostics, 11.","DOI":"10.3390\/diagnostics11050855"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Ricchio, M., Tassone, B., Pelle, M., Mazzitelli, M., Serapide, F., Fusco, P., Lionello, R., Cancelliere, A., Procopio, G., and Lio, E. (2021). Characteristics, Management, and Outcomes of Elderly Patients with Diabetes in a Covid-19 Unit: Lessons Learned from a Pilot Study. Medicina, 57.","DOI":"10.3390\/medicina57040341"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/ane.13266","article-title":"Neurological Manifestations of COVID-19: A systematic review and current update","volume":"142","author":"Whittaker","year":"2020","journal-title":"Acta Neurol. Scand."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1016\/S0140-6736(21)00517-1","article-title":"Guillain-Barr\u00e9 syndrome","volume":"397","author":"Shahrizaila","year":"2021","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1212\/WNL.48.3.717","article-title":"Motor nerve terminal degeneration provides a potential mechanism for rapid recovery in acute motor axonal neuropathy after campylobacter infection","volume":"48","author":"Ho","year":"1997","journal-title":"Neurology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2866","DOI":"10.1093\/brain\/awy232","article-title":"Regional variation of Guillain-Barr\u00e9 syndrome","volume":"141","author":"Doets","year":"2018","journal-title":"Brain"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1038\/s41582-019-0250-9","article-title":"Diagnosis and management of Guillain\u2013Barr\u00e9 syndrome in ten steps","volume":"15","author":"Leonhard","year":"2019","journal-title":"Nat. Rev. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"322","DOI":"10.4103\/1817-1745.199480","article-title":"Acute bulbar palsy plus syndrome: A rare variant of Guillain\u2013Barre syndrome","volume":"11","author":"Ray","year":"2016","journal-title":"J. Pediatr. Neurosci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2294","DOI":"10.1056\/NEJMra1114525","article-title":"Guillain\u2013Barr\u00e9 Syndrome","volume":"366","author":"Yuki","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1159\/000324710","article-title":"Population Incidence of Guillain-Barr\u00e9 Syndrome: A Systematic Review and Meta-Analysis","volume":"36","author":"Sejvar","year":"2011","journal-title":"Neuroepidemiology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1136\/jnnp-2020-324837","article-title":"Guillain-Barr\u00e9 syndrome and COVID-19: An observational multicentre study from two Italian hotspot regions","volume":"92","author":"Filosto","year":"2020","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1212\/01.wnl.0000310983.38724.d4","article-title":"Guillain-Barre syndrome: Incidence and mortality rates in US hospitals","volume":"70","author":"Alshekhlee","year":"2008","journal-title":"Neurology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"383","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":"Zhao","year":"2020","journal-title":"Lancet Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1002\/ana.25987","article-title":"Incidence, clinical, risk factors and outcomes of Guillain-Barr\u00e9 in COVID-19","volume":"89","author":"Fragiel","year":"2020","journal-title":"Ann. Neurol."},{"key":"ref_19","unstructured":"(2022, July 17). National Institute of Public Health, Romania, Available online: https:\/\/insp.gov.ro\/centrul-national-de-supraveghere-si-control-al-bolilor-transmisibile-cnscbt\/infectia-cu-noul-coronavirus-sars-cov-2\/analiza-cazuri-confirmate-covid19\/."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"792","DOI":"10.31925\/farmacia.2020.5.4","article-title":"Influence of tocilizumab on the outcome of patients with COVID-19. retrospective observational study","volume":"68","author":"Davidescu","year":"2020","journal-title":"Farmacia"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"597","DOI":"10.31925\/farmacia.2020.4.3","article-title":"Treatment with hydroxychloroquine in patients with covid-19. Experience of a neurology department","volume":"68","author":"Davidescu","year":"2020","journal-title":"Farmacia"},{"key":"ref_22","first-page":"513","article-title":"Guillain-Barr\u00e9 syndrome associated with SARS-CoV-2 infection","volume":"44","author":"Molina","year":"2020","journal-title":"Med. Intensiva"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3595","DOI":"10.1007\/s00415-021-10515-8","article-title":"Could symptom overlap of COVID-19 and Guillain\u2013Barr\u00e9 syndrome mask an epidemiological association?","volume":"268","author":"Kohle","year":"2021","journal-title":"J. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"106413","DOI":"10.1016\/j.clineuro.2020.106413","article-title":"Guillain-Barre Syndrome and COVID-19: A case report","volume":"200","author":"Bueso","year":"2020","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1159\/000513382","article-title":"Guillain-Barre Syndrome following COVID-19 Infection: First Case Report from Kuwait and Review of the Literature","volume":"4","author":"Kamel","year":"2021","journal-title":"Dubai Med. J."},{"key":"ref_26","first-page":"e13828","article-title":"Association of Guillain-Barre Syndrome with COVID-19: A Case Report and Literature Review","volume":"13","author":"Singh","year":"2021","journal-title":"Cureus"},{"key":"ref_27","first-page":"e21246","article-title":"COVID-19 and Guillain-Barre Syndrome Case Report","volume":"7","author":"Sidig","year":"2020","journal-title":"J. Neurol. Neurobiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e236182","DOI":"10.1136\/bcr-2020-236182","article-title":"Guillain-Barr\u00e9 syndrome following COVID-19: A newly emerging post-infectious complication","volume":"13","author":"Webb","year":"2020","journal-title":"BMJ Case Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e237215","DOI":"10.1136\/bcr-2020-237215","article-title":"Guillain-Barr\u00e9 syndrome associated with COVID-19 disease","volume":"13","author":"Korem","year":"2020","journal-title":"BMJ Case Rep."},{"key":"ref_30","first-page":"7","article-title":"Guillain-BarrE Syndrome Following COVID-19: A Case Report","volume":"9","author":"Almutairi","year":"2021","journal-title":"J. Res. Med. Dent. Sci."},{"key":"ref_31","first-page":"251","article-title":"Novel Coronavirus (COVID-19)-Associated Guillain\u2013Barre\u2019 Syndrome: Case Report","volume":"14","author":"Mantefardo","year":"2021","journal-title":"Int. Med. Case Rep. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.neurol.2020.04.003","article-title":"COVID-19 may induce Guillain\u2013Barr\u00e9 syndrome","volume":"176","author":"Camdessanche","year":"2020","journal-title":"Rev. Neurol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.jocn.2020.04.062","article-title":"Guillain Barre syndrome associated with COVID-19 infection: A case report","volume":"76","author":"Sedaghat","year":"2020","journal-title":"J. Clin. Neurosci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e00771","DOI":"10.1016\/j.idcr.2020.e00771","article-title":"Guillain-Barr\u00e9 Syndrome associated with SARS-CoV-2 infection","volume":"20","author":"Virani","year":"2020","journal-title":"IDCases"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jocn.2020.05.016","article-title":"Facial diplegia, a possible atypical variant of Guillain-Barr\u00e9 Syndrome as a rare neurological complication of SARS-CoV-2","volume":"77","author":"Beato","year":"2020","journal-title":"J. Clin. Neurosci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.bbi.2020.04.074","article-title":"Guillain-Barr\u00e9 syndrome as a complication of SARS-CoV-2 infection","volume":"87","author":"Coen","year":"2020","journal-title":"Brain Behav. Immun."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e741","DOI":"10.1212\/NXI.0000000000000741","article-title":"Guillain-Barr\u00e9 syndrome related to COVID-19 infection","volume":"7","author":"Alberti","year":"2020","journal-title":"Neurol. Neuroimmunol. Neuroinflamma."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1016\/j.jemermed.2021.03.022","article-title":"Guillain-Barr\u00e9 Syndrome after Novel Coronavirus Disease 2019","volume":"61","author":"Yakoby","year":"2021","journal-title":"J. Emerg. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.nmd.2020.08.354","article-title":"Guillain-Barr\u00e9-Strohl syndrome and COVID-19: Case report and literature review","volume":"30","author":"Vidal","year":"2020","journal-title":"Neuromuscul. Disord."},{"key":"ref_40","first-page":"2324709620961198","article-title":"A Case of Guillain-Barr\u00e9 Syndrome Associated With COVID-19","volume":"8","author":"Rajdev","year":"2020","journal-title":"J. Investig. Med. High Impact Case Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1097\/CND.0000000000000309","article-title":"Novel Coronavirus (COVID-19)-Associated Guillain\u2013Barr\u00e9 Syndrome: Case Report","volume":"21","author":"Rana","year":"2020","journal-title":"J. Clin. Neuromuscul. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Mackenzie, N., Lopez-Coronel, E., Dau, A., Maloof, D., Mattar, S., Garcia, J.T., Fontecha, B., Lanata, C.M., and Guillen-Burgos, H.F. (2021). Concomitant Guillain-Barre syndrome with COVID-19: A case report. BMC Neurol., 21.","DOI":"10.1186\/s12883-021-02162-3"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Yiu, A.C., Hussain, A., Okonkwo, U.A., Villacorta-Lyew, R., McMahon, M.J., and Blattner, M. (2021). Guillain\u2013Barre Syndrome Associated with COVID-19 Pneumonia\u2014The First Documented Case in a U.S. Military Intensive Care Unit. Mil. Med., usab158.","DOI":"10.1093\/milmed\/usab158"},{"key":"ref_44","first-page":"e576","article-title":"A Case Series of Guillain-Barr\u00e9 Syndrome After COVID-19 Infection in New York","volume":"11","author":"Chan","year":"2020","journal-title":"Neurol. Clin. Pract."},{"key":"ref_45","first-page":"122","article-title":"Guillain-Barre syndrome in patients with coronavirus disease-2019: Report of six cases and review of literature","volume":"19","author":"Okhovat","year":"2021","journal-title":"Curr. J. Neurol."},{"key":"ref_46","first-page":"e601","article-title":"Miller Fisher syndrome and polyneuritis cranialis in COVID-19","volume":"95","year":"2020","journal-title":"Neurology"},{"key":"ref_47","first-page":"e84","article-title":"COVID-19 provoking Guillain\u2013Barr\u00e9 syndrome: The Bergamo case series","volume":"28","author":"Foresti","year":"2020","journal-title":"Eur. J. Neurol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2574","DOI":"10.1056\/NEJMc2009191","article-title":"Guillain\u2013Barr\u00e9 Syndrome Associated with SARS-CoV-2","volume":"382","author":"Toscano","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.ajem.2020.09.029","article-title":"COVID-19 associated Guillain-Barre Syndrome: Contrasting tale of four patients from a tertiary care centre in India","volume":"39","author":"Nanda","year":"2020","journal-title":"Am. J. Emerg. Med."},{"key":"ref_50","first-page":"1133","article-title":"Guillain\u2013Barr\u00e9 syndrome spectrum associated with COVID-19: An up-to-date systematic review of 73 cases","volume":"268","author":"Abdelhak","year":"2020","journal-title":"J. Neurol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"17534666221110346","DOI":"10.1177\/17534666221110346","article-title":"Comparison of initial clinic characteristics of hospitalized patients in Suzhou City during the COVID-19 Omicron wave with ancestral variant wave","volume":"16","author":"Gu","year":"2022","journal-title":"Ther. Adv. Respir. Dis."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.jocn.2020.11.013","article-title":"Guillain\u2013Barr\u00e9 syndrome as a parainfectious manifestation of SARS-CoV-2 infection: A case series","volume":"83","author":"Abolmaali","year":"2020","journal-title":"J. Clin. Neurosci."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1007\/s10072-020-04449-8","article-title":"Early Guillain-Barr\u00e9 syndrome in coronavirus disease 2019 (COVID-19): A case report from an Italian COVID-hospital","volume":"41","author":"Ottaviani","year":"2020","journal-title":"Neurol. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1056\/NEJMoa1605564","article-title":"Guillain\u2013Barr\u00e9 Syndrome Associated with Zika Virus Infection in Colombia","volume":"375","author":"Parra","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1212\/WNL.0b013e3182904fcc","article-title":"Mortality in Guillain-Barre syndrome","volume":"80","author":"Berg","year":"2013","journal-title":"Neurology"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/977\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:54:54Z","timestamp":1760140494000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/8\/977"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,22]]},"references-count":55,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["medicina58080977"],"URL":"https:\/\/doi.org\/10.3390\/medicina58080977","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,22]]}}}