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Multicenter Study
. 2022 Sep 15:440:120330.
doi: 10.1016/j.jns.2022.120330. Epub 2022 Jun 25.

COVID-19 vaccine-related Guillain-Barré syndrome in the Liguria region of Italy: A multicenter case series

Francesco Germano  1 , Margherita Bellucci  1 , Stefano Grisanti  1 , Alessandro Beronio  2 , Matteo Grazzini  2 , Elena Coco  3 , Tiziana Tassinari  3 , Fabio Della Cava  4 , Chiara De Michelis  4 , Ottavia Baldi  5 , Giorgia Sivori  6 , Alessandra Murialdo  7 , Corrado Cabona  7 , Paolo Durando  7 , Antonio Uccelli  7 , Angelo Schenone  8 , Diego Franciotta  7 , Luana Benedetti  9
Affiliations
Multicenter Study

COVID-19 vaccine-related Guillain-Barré syndrome in the Liguria region of Italy: A multicenter case series

Francesco Germano et al. J Neurol Sci. .

Abstract

Background and purpose: Guillain-Barré-Syndrome (GBS) can follow COVID-19 vaccination, with clinical and paraclinical features still to be precisely assessed. We describe a cohort of patients who developed GBS after vaccination with different types of COVID-19 vaccines.

Methods: Patients with post-COVID-19 vaccination GBS, admitted to the six hospitals that cover the whole Liguria Region, Northwestern Italy, from February 1st to October 30th 2021, were included. Clinical, demographic, and paraclinical data were retrospectively collected.

Results: Among the 13 patients with post-COVID-19 vaccination GBS (9 males; mean age, 64 year), 5 were vaccinated with Oxford-AstraZeneca, 7 with Pfizer-BioNTech, and one with Moderna. Mean time between vaccination and GBS onset was 11.5 days. Ten patients developed GBS after the first vaccination dose, 3 after the second dose. Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) was the predominant GBS variant, mainly characterized by sensory involvement. Bilateral seventh cranial nerve involvement followed AstraZeneca vaccination in two cases. Three patients presented treatment-related fluctuations, and 4 mild symptoms that delayed treatments and negatively affected prognosis. Prognosis was poor (GBS-disability score, ≥3) in 5/13 patients, with a disability rate of 3/13.

Conclusions: Our findings confirm that most post-COVID-19 vaccination GBS belong to the AIDP subtype, and occur after the first vaccine dose. Treatment-related fluctuations, and diagnosis-delaying, mild symptoms at onset are clinical features that affect prognosis and deserve particular consideration.

Keywords: Adverse event; COVID-19; Guillain-Barré syndrome; Peripheral nervous system; Prognosis; SARS-CoV-2; Vaccination.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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