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: