{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:38:33Z","timestamp":1760150313984,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T00:00:00Z","timestamp":1699228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>The virus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) is capable of attacking the nervous system in several ways and leading to neurological diseases such as GBS (Guillain\u2013Barr\u00e9 syndrome) through the resulting neurotropism and immune response. The aim of this study is to show the relationship between Coronavirus disease (COVID-19) and GBS and to better understand the clinical symptoms to prevent poor outcomes. Data from 15 patients were extracted from the Department of Neurology, University Hospital of Split, Croatia, for the year 2021. The age of the patients ranged from 26 to 89 years, of whom 27% were women. Sixty seven percent of all GBS patients recovered from COVID-19 infection, whereas post-vaccinal polyradiculoneuritis was detected in 6%. Forty four percent of the patients who developed GBS had a severe form of COVID-19 infection. Forty percent of patients were treated with intravenous immunoglobulins (IVIG), followed by therapeutic plasma exchange (PLEX) in 27%. After the therapy, improvement was observed in 13 patients, while two patients died. The results suggest that SARS-CoV-2 triggers GBS because it follows a similar pattern of infection as the other viral and bacterial agents that contribute to the onset of GBS. There is no evidence that prior infection with COVID-19 worsens the clinical presentation of GBS.<\/jats:p>","DOI":"10.3390\/neurolint15040086","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T01:37:09Z","timestamp":1699234629000},"page":"1359-1370","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Analysis of Post-COVID-19 Guillain\u2013Barr\u00e9 Syndrome over a Period of One Year in the University Hospital of Split (Croatia)"],"prefix":"10.3390","volume":"15","author":[{"given":"Niko","family":"Dunki\u0107","sequence":"first","affiliation":[{"name":"Practice of General Medicine, A.G. Mato\u0161a 2, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4976-5392","authenticated-orcid":false,"given":"Marija","family":"Nazli\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Science, University of Split, Ru\u0111era Bo\u0161kovi\u0107a 33, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9372-7337","authenticated-orcid":false,"given":"Valerija","family":"Dunki\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Science, University of Split, Ru\u0111era Bo\u0161kovi\u0107a 33, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivica","family":"Bili\u0107","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Split, \u0160oltanska 2, 21000 Split, Croatia"},{"name":"Neurology Department, University Hospital Split, Spin\u010di\u0107eva 1, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,6]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Inflammatory Polyradiculoneuropathies: Clinical and Immunological Aspects, Current Therapies, and Future Perspectives","volume":"18","author":"Barbone","year":"2020","journal-title":"Eur. J. Inflamm."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s10286-018-0542-y","article-title":"Autonomic Involvement in Guillain\u2013Barr\u00e9 Syndrome: An Update","volume":"29","author":"Zaeem","year":"2019","journal-title":"Clin. Auton. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1055\/s-0039-1693005","article-title":"Guillain-Barre Syndrome","volume":"39","author":"Malek","year":"2019","journal-title":"Semin. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1136\/jnnp-2012-302824","article-title":"Bickerstaff Brainstem Encephalitis and Fisher Syndrome: Anti-GQ1b Antibody Syndrome","volume":"84","author":"Shahrizaila","year":"2013","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/jns.12502","article-title":"Epidemiology of Chronic Inflammatory Demyelinating Polyradiculoneuropathy in The Netherlands","volume":"27","author":"Broers","year":"2022","journal-title":"J. Peripher. Nerv. Syst."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Bentley, S.A., Ahmad, S., Kobeissy, F.H., and Toklu, H.Z. (2022). Concomitant Guillain\u2013Barr\u00e9 Syndrome and COVID-19: A Meta-Analysis of Cases. Medicina, 58.","DOI":"10.3390\/medicina58121835"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"11404","DOI":"10.1073\/pnas.0402391101","article-title":"Carbohydrate Mimicry between Human Ganglioside GM1 and Campylobacter Jejuni Lipooligosaccharide Causes Guillain-Barr\u00e9 Syndrome","volume":"101","author":"Yuki","year":"2004","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/S0140-6736(16)00339-1","article-title":"Guillain-Barr\u00e9 Syndrome","volume":"388","author":"Willison","year":"2016","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1016\/S0140-6736(21)00517-1","article-title":"Guillain-Barr\u00e9 Syndrome","volume":"397","author":"Shahrizai","year":"2021","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1038\/nrneurol.2014.121","article-title":"Guillain-Barr\u00e9 Syndrome: Pathogenesis, Diagnosis, Treatment and Prognosis","volume":"10","author":"Walgaard","year":"2014","journal-title":"Nat. Rev. Neurol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1038\/s41579-020-00459-7","article-title":"Characteristics of SARS-CoV-2 and COVID-19","volume":"19","author":"Hu","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical Characteristics of Coronavirus Disease 2019 in China","volume":"382","author":"Guan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e13868","DOI":"10.1111\/ijcp.13868","article-title":"Novel Coronavirus Disease (COVID-19) Update on Epidemiology, Pathogenicity, Clinical Course and Treatments","volume":"75","author":"Boban","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1007\/s00408-020-00408-4","article-title":"ACE2: The Major Cell Entry Receptor for SARS-CoV-2","volume":"198","author":"Scialo","year":"2020","journal-title":"Lung"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"26","DOI":"10.5603\/PJNNS.a2023.0009","article-title":"Impact of SARS-CoV-2 on the Nervous System","volume":"57","author":"Czarnowska","year":"2023","journal-title":"Neurol. Neurochir. Pol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"577436","DOI":"10.1016\/j.jneuroim.2020.577436","article-title":"SARS-CoV-2 and Nervous System: From Pathogenesis to Clinical Manifestation","volume":"350","author":"Keyhanian","year":"2021","journal-title":"J. Neuroimmunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2657","DOI":"10.1007\/s10072-020-04575-3","article-title":"Neuroinvasion, Neurotropic, and Neuroinflammatory Events of SARS-CoV-2: Understanding the Neurological Manifestations in COVID-19 Patients","volume":"41","author":"Yachou","year":"2020","journal-title":"Neurol. Sci."},{"key":"ref_18","unstructured":"(2023). Croatia National Institute of Public Health COVID-19 Report 2020\u20132022, Croatian National Institute of Public Health. Available online: https:\/\/ghdx.healthdata.org\/record\/croatia-national-institute-public-health-covid-19-report-2020-2022."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1093\/brain\/awt285","article-title":"Diagnosis of Guillain-Barr\u00e9 Syndrome and Validation of Brighton Criteria","volume":"137","author":"Fokke","year":"2014","journal-title":"Brain"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1093\/infdis\/175.Supplement_1.S151","article-title":"Assessment of Guillain-Barre Syndrome Mortality and Morbidity in the United States: Implications for Acute Flaccid Paralysis Surveillance","volume":"175","author":"Prevots","year":"1997","journal-title":"J. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/s12974-021-02319-4","article-title":"Global, Regional, and National Burden of Guillain\u2013Barr\u00e9 Syndrome and Its Underlying Causes from 1990 to 2019","volume":"18","author":"Bragazzi","year":"2021","journal-title":"J. Neuroinflamm."},{"key":"ref_22","unstructured":"(2022, June 30). Statista Total Number of Cases of COVID-19 in the United States as of 17 June 2022, by Age Group. Available online: https:\/\/www.statista.com\/statistics\/1254477\/weekly-number-of-covid-19-hospitalizations-in-the-us-by-age."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"111793","DOI":"10.1016\/j.mad.2023.111793","article-title":"Sex Differences in Neuromuscular Disorders","volume":"211","author":"Vinciguerra","year":"2023","journal-title":"Mech. Ageing Dev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3392","DOI":"10.1093\/brain\/awab279","article-title":"Guillain-Barr\u00e9 Syndrome after SARS-CoV-2 Infection in an International Prospective Cohort Study","volume":"144","author":"Luijten","year":"2021","journal-title":"Brain"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1002\/path.5471","article-title":"Angiotensin-Converting Enzyme 2 (ACE2), SARS-CoV-2 and the Pathophysiology of Coronavirus Disease 2019 (COVID-19)","volume":"251","author":"Bourgonje","year":"2020","journal-title":"J. Pathol."},{"key":"ref_26","first-page":"469","article-title":"Risk Factors for COVID-19","volume":"4","author":"Jalil","year":"2020","journal-title":"Infez. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.3389\/fimmu.2020.02147","article-title":"What\u2019s Sex Got to Do With COVID-19? Gender-Based Differences in the Host Immune Response to Coronaviruses","volume":"11","author":"Gadi","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_28","unstructured":"(2022, January 20). Population Census for 2021, Croatian Bureau of Statistics, Available online: https:\/\/dzs.gov.hr\/vijesti\/objavljeni-konacni-rezultati-popisa-2021\/1270."},{"key":"ref_29","unstructured":"Pelivan, A. (2017). The Incidence of Acute Inflammatory Polyradiculoneuropathy in Clinical Hospital Center Split in the Period from 2012 to 2016, School of Medicine, University of Split."},{"key":"ref_30","unstructured":"(2013). Aleraj Borislav Infectious Diseases in Croatia in 2012. Croat. J. Infect., 33, 127\u2013133."},{"key":"ref_31","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":"2021","journal-title":"Ann. Neurol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3358","DOI":"10.1111\/ene.15497","article-title":"Guillain-Barr\u00e9 Syndrome and COVID-19: A 1-Year Observational Multicenter Study","volume":"29","author":"Filosto","year":"2022","journal-title":"Eur. J. Neurol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s00508-020-01760-4","article-title":"Clinical Manifestations of COVID-19 in the General Population: Systematic Review","volume":"133","year":"2021","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1002\/mus.27024","article-title":"COVID-19\u2013Associated Guillain-Barr\u00e9 Syndrome: The Early Pandemic Experience","volume":"62","author":"Caress","year":"2020","journal-title":"Muscle Nerve"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1080\/1744666X.2016.1193006","article-title":"Guillain-Barr\u00e9 Syndrome: Causes, Immunopathogenic Mechanisms and Treatment","volume":"12","author":"Jasti","year":"2016","journal-title":"Expert. Rev. Clin. Immunol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1007\/s00415-020-10124-x","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":"2021","journal-title":"J. Neurol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Iacono, S., Di Stefano, V., Alonge, P., Vinciguerra, C., Milella, G., Caputo, F., Lasorella, P., Neto, G., Pignolo, A., and Torrente, A. (2022). Adherence and Reactogenicity to Vaccines against SARS-CoV-2 in 285 Patients with Neuropathy: A Multicentric Study. Brain Sci., 12.","DOI":"10.3390\/brainsci12101396"}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/15\/4\/86\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:17:57Z","timestamp":1760131077000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/15\/4\/86"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,6]]},"references-count":37,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["neurolint15040086"],"URL":"https:\/\/doi.org\/10.3390\/neurolint15040086","relation":{},"ISSN":["2035-8377"],"issn-type":[{"type":"electronic","value":"2035-8377"}],"subject":[],"published":{"date-parts":[[2023,11,6]]}}}