tetano
Editor, Senior Moderator
Front Immunol
. 2023 Aug 28;14:1258579.
doi: 10.3389/fimmu.2023.1258579. eCollection 2023. Case Report: Four cases of SARS-CoV-2-associated Guillain-Barré Syndrome with SARS-CoV-2-positive cerebrospinal fluid detected by metagenomic next-generation sequencing: a retrospective case series from China
Yalin Guan[SUP] 1 [/SUP], Changshen Yu[SUP] 1 [/SUP], Yunhan Fei[SUP] 2 [/SUP], Qiushi Wang[SUP] 3 4 [/SUP], Pan Wang[SUP] 1 [/SUP], Wenchao Zuo[SUP] 1 [/SUP], Hao Wu[SUP] 1 [/SUP], Xuemei Qi[SUP] 5 [/SUP], Qiyun Shi[SUP] 3 4 [/SUP]
Affiliations
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is often absent or at low levels in the cerebrospinal fluid (CSF) of patients with previous SARS-CoV-2-associated Guillain-Barré syndrome (GBS). This has led to speculation that SARS-CoV-2-associated GBS is more likely mediated by post-infectious immunity or a parainfection. This understanding has influenced the development of treatment regimens for SARS-CoV-2-associated GBS. This paper reports our experience with four Chinese patients with SARS-CoV-2-associated GBS who tested positive for SARS-CoV-2 RNA in the CSF. They developed symptoms of peripheral nerve damage 4-15 days after fever and confirmed SARS-CoV-2 infection, all of whom presented with progressive weakness of both lower limbs; three with autonomic nerve function impairment such as constipation and urination disorder; and one with polycranial neuritis and Miller-Fisher syndrome. Three patients were tested for anti-ganglioside antibodies, and one tested positive for GD1a-IgG. Four patients recovered well after treatment with anti-viral drugs combined with intravenous immunoglobulin. The present results showed that SARS-CoV-2 RNA can be detected via mNGS in the CSF of some patients with SARS-CoV-2-associated GBS, suggesting that SARS-CoV-2-associated GBS may have multiple pathogeneses.
Keywords: COVID-19; Guillain-Barré Syndrome; SARS-CoV-2; cerebrospinal fluid; metagenomic next-generation sequencing.
. 2023 Aug 28;14:1258579.
doi: 10.3389/fimmu.2023.1258579. eCollection 2023. Case Report: Four cases of SARS-CoV-2-associated Guillain-Barré Syndrome with SARS-CoV-2-positive cerebrospinal fluid detected by metagenomic next-generation sequencing: a retrospective case series from China
Yalin Guan[SUP] 1 [/SUP], Changshen Yu[SUP] 1 [/SUP], Yunhan Fei[SUP] 2 [/SUP], Qiushi Wang[SUP] 3 4 [/SUP], Pan Wang[SUP] 1 [/SUP], Wenchao Zuo[SUP] 1 [/SUP], Hao Wu[SUP] 1 [/SUP], Xuemei Qi[SUP] 5 [/SUP], Qiyun Shi[SUP] 3 4 [/SUP]
Affiliations
- PMID: 37701436
- PMCID: PMC10493301
- DOI: 10.3389/fimmu.2023.1258579
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is often absent or at low levels in the cerebrospinal fluid (CSF) of patients with previous SARS-CoV-2-associated Guillain-Barré syndrome (GBS). This has led to speculation that SARS-CoV-2-associated GBS is more likely mediated by post-infectious immunity or a parainfection. This understanding has influenced the development of treatment regimens for SARS-CoV-2-associated GBS. This paper reports our experience with four Chinese patients with SARS-CoV-2-associated GBS who tested positive for SARS-CoV-2 RNA in the CSF. They developed symptoms of peripheral nerve damage 4-15 days after fever and confirmed SARS-CoV-2 infection, all of whom presented with progressive weakness of both lower limbs; three with autonomic nerve function impairment such as constipation and urination disorder; and one with polycranial neuritis and Miller-Fisher syndrome. Three patients were tested for anti-ganglioside antibodies, and one tested positive for GD1a-IgG. Four patients recovered well after treatment with anti-viral drugs combined with intravenous immunoglobulin. The present results showed that SARS-CoV-2 RNA can be detected via mNGS in the CSF of some patients with SARS-CoV-2-associated GBS, suggesting that SARS-CoV-2-associated GBS may have multiple pathogeneses.
Keywords: COVID-19; Guillain-Barré Syndrome; SARS-CoV-2; cerebrospinal fluid; metagenomic next-generation sequencing.