Brief Follow Up

By Dr Gareth Parry (ONZM, MB, ChB, FRACP)

Emeritus Professor, Neurology, University of Minnesota, USA

Clinical Senior Lecturer, Otago University, Wellington, NZ

Research Professor, Nelson-Marlborough Institute of Technology, NZ

Visiting Neurologist, Wellington Hospital, NZ

  GBS Support Group Medical Advisor

Medical Advisory Board, GBS/CIDP Foundation International

This “rapidly evolving field”, to quote my previous communication, has indeed rapidly evolved.  In this week’s New England Journal of Medicine, the top-rated clinical medical journal in the world, there is a report of five patients who developed GBS associated with COVID-19 infection.  This report is much more persuasive than the prior one I wrote about.  I have reviewed the clinical reports and there is no doubt that they did have GBS and the interval between the infection and the onset of GBS was 5-10 days, typical of the interval for other infections.  Also, the number of cases seen from a relatively small population in Northern Italy suggest that the association was not coincidental.  These five GBS cases occurred among about 1200 COVID-19 patients admitted to the same hospitals but, of course, there were many other cases admitted to other hospitals and occurring in the community but not admitted to a hospital.  Nonetheless, this report does suggest that COVID-19 may be a GBS trigger for some susceptible individuals.  Whether this is just a nonspecific viral trigger or will represent an increased susceptibility with COVID-19, resembles that seen with the EB virus (that causes glandular fever) and Zika virus remains to be seen.  I have requested that my neurological colleagues around NZ test all GBS patients for COVID-19 and to communicate the result to Dr Taylor or to me.  It will be interesting to see if there is a spike in GBS cases during this epidemic.

For those wishing to read about the cases the link to the article is:

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