What is the Guillain-Barre syndrome that some COVID-19 patients develop?

New Delhi, Nov 19: In some rare cases, people with severe COVID-19 may develop the serious nervous system disorder known as Guillain-Barre syndrome (GBS). In India, such cases have been reported since August.

A group of neurologists in Mumbai is now mapping these cases and their symptoms. So far, 24 cases have been added to the study.

Guillain-Barre syndrome, caused by bacteria or viral infection, is a well-known condition in which one's immune system targets peripheral nerves as foreign and attacks them, resulting in the cardinal features of the disease.

The symptoms of the disorder include reflex loss, muscle weakness, numbness or tingling sensation in parts of the body and temporary paralysis.

The paralysis can become permanent if ignored. Most patients completely recover but paralysis in limb can last longer for some people.

Guillain-Barré syndrome and coronavirus

The immune system, in an attempt to kill the coronavirus, accidentally starts attacking the peripheral nervous system. The peripheral nervous system is a network of nerves that lead from the brain and spinal cord to different parts of the body. Attacking them can affect limb functions.

The first symptoms are a tingling or itching sensation in the skin,may emerge first in feet and hands. A person then starts experiencing reflex loss and paralysis, which may be temporary, but can last for 6-12 months or longer. With Covid-19 a year old, it is still difficult to assess the nature of permanency GBS in such cases may present.

According to the Italian authors of a new study, the syndrome has also been seen in patients battling Epstein-Barr virus, cytomegalovirus and, most notably, infection with mosquito-borne Zika.

The New England Journal of Medicine, the authors said that between Feb 28 and March 21, three hospitals in the region treated about 1,200 patients with COVID-19. Five of those patients displayed symptoms most likely caused by Guillain-Barre.

Symptoms of Guillain-Barre tended to arise within 5 to 10 days of the first onset of common COVID-19 symptoms, the researchers said. Within another two days, neurologic symptoms got worse until all four limbs were weakened or paralyzed, the Italian group said.

Coronavirus can trigger an immune response so powerful that the body's peripheral nervous system can come under attack.

The British Medical Journal published a similar case from Japan last month, where a 54-year-old woman developed numbness and weakness and required two week hospitalisation. Tests showed she had pneumonia in chest, and her Covid-19 report came positive.

"GBS can leave behind permanent neurological damage. Most will completely recover but some may have paralysis in limb and weakness in body for a longer period," Agrawal says.

A multi-doctor team led by Dr Megha Dhamne, neurologist in Dr LH Hiranandani hospital, Powai, says "GBS can leave behind permanent neurological damage. Most will completely recover but some may have paralysis in limb and weakness in body for a longer period."