corona virus-Covid19

Guillain-Barré Syndrome following ChAdOx1-S/nCoV-19 Vaccine Interview with:
Dr Boby Varkey Maramattom

Fellow in Critical care neurology (Mayo Clinic)
Lead Consultant Neurologist
Aster Medcity, Kochi, Kerala
Associate Director- Clinical Research Centre, Aster Medcity.
Convener, Neurocritical care subsection
Indian academy of Neurology  (IAN) What is the background for this study?

Response:  Approximately 2-3 months after the vaccination programme commenced in India, we began to notice an uptick in the incidence of Guillain-Barré Syndrome (GBS) in our community. All the cases that presented to us during this period had almost the same clinical presentation. They presented within a few days ( usually within 1-2 weeks) of the first dose of the ChAdOx1-S/nCoV-19 vaccine. Most of the patients were women and it seemed to involve the middle aged to elderly age groups. As a result of this observation, we started to compile the clinical findings of these patients and collate them. What are the main findings? Is there a different incidence among the COVID-19 variants?

Response: The main findings were a high incidence of bifacial palsy and a higher than expected (20%) incidence of other cranial neuropathies (such as trigeminal and abducens palsies). These unusual cranial neuropathies (V and VI) are seen in < 5% of patients with GBS from India.  Most of our patients developed rapidly progressive and severe weakness that progressed to respiratory weakness and mechanical ventilation. At the time of publication, most of our patients were still disabled and in rehabilitation. Since then, we have encountered 5-6 more cases of Guillain-Barré Syndrome in our community with almost the same presentation.Unfortunately we could not perform viral genetic strain assessment due to cost considerations. What should readers take away from your report?

Response: They should know that Guillain-Barré Syndrome can occur after the ChAdOx1-S/nCoV-19 vaccine or possibly other adeno vector viral vaccines. Rather than brushing away the association, it is important to report this association to the relevant health authorities. Moreover, rigorous scientific study into the mechanisms of GBS after vaccination may ultimately lead to safer vaccines.  The risks of GBS after vaccination are still very low and are eclipsed by the benefits of vaccination. Therefore, these rare side effects should not dissuade the community from the benefits of COVID vaccination. Rather, they should act as a monitoring mechanism and a potential tool to improve vaccine safety. 

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Maramattom, B.V., Krishnan, P., Paul, R., Padmanabhan, S., Cherukudal Vishnu Nampoothiri, S., Syed, A.A. and Mangat, H.S. (2021), Guillain-Barré Syndrome following ChAdOx1-S/nCoV-19 Vaccine. Ann Neurol. is not a forum for the exchange of personal medical information, advice or the promotion of self-destructive behavior (e.g., eating disorders, suicide). While you may freely discuss your troubles, you should not look to the Website for information or advice on such topics. Instead, we recommend that you talk in person with a trusted medical professional.

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Last Updated on June 22, 2021 by Marie Benz MD FAAD