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Study Finds No Guillain-Barré Risk with COVID-19 Infection, Virus

With the first COVID-19 vaccine receiving emergency use authorization, anti-vaxxers are working overtime to persuade people not to get it. Find out how a new study dealt with one potential issue – increased risk of Guillain-Barré syndrome – and determined it has been no problem with the novel coronavirus and isn’t likely to be with a vaccine.

LONDON – While concerns have been raised during past mass immunization efforts about the risk of a possibly related neurological condition, a new study finds now link between COVID-19 – or the vaccination against it -- and Guillain-Barré syndrome.

The article in the journal Brain notes that GBS, a rare but serious autoimmune condition that attacks the peripheral nervous system, often occurs after Camplylobacter, a gastroenteritis infection, when the immune system mistakenly attacks nerves. The condition usually is reversible, although, in severe case, it can cause prolonged paralysis and sometimes requires temporary ventilator support.

University College London-led researchers say the virus has been associated in the past with some viruses and vaccines.

For example, they point out that more cases of GBS were associated with the Zika virus outbreaks in Latin America in 2016 and 2020 than anticipated by chance alone. Questions have been raised about whether a similar situation could occur with COVID-19 infection and GBS too.

In addition, there was a small increase in GBS associated with the 1976 swine flu vaccination campaign in the United States, which led to its suspension. The authors explain that subsequent statistical analysis found the risk of a link to be lower than initially thought. Now, the risk of GBS as a result of flu vaccination is estimated to be about one per million vaccination doses.

For the epidemiological and cohort study, the study team assessed the number of GBS treatments reported to the NHS England National Immunoglobulin Database between 2016 and 2019, comparing it to the number of cases reported during the COVID-19 pandemic in the first half of 2020.

The authors determined that the annual incidence of GBS treated in UK hospitals between 2016 and 2019 was 1.65-1.88 per 100,000 individuals and that incidences of GBS actually fell 40-50% between March and May 2020 when compared to the same months of 2016-2019.

"The possibility of SARS-CoV-2 driving a global spike in GBS has been eagerly monitored with a number of published small case series already asserting a causal link. However, a surge in GBS cases after the SARS-CoV-2 pandemic has not been detected as happened in the Zika virus pandemic,” said first author Stephen Keddie, MBBS. "Our epidemiological study shows there was no increased incidence in GBS during the first wave of COVID-19; rather, there was a decrease and therefore no causal link of COVID-19 to GBS can be made."

Also in the study, researchers sought to determine if there was any genetic or protein structure in SARS-CoV-2, the virus that causes COVID-19, which could trigger an immune response causing GBS. Unlike Camplylobacter, which contains human-like antigens causing an autoimmune response, they found no credible link with SARS-CoV-2.

"Most COVID-19 vaccinations are based on the SARS-CoV-2 spike protein, which drives a complex immune response creating antibodies to fight infection,” Keddie described. “"Our analysis shows SARS-CoV-2 contains no additional immunogenic material known or proven to drive GBS. Concerns that COVID vaccination might cause GBS in any significant numbers are therefore almost certainly unfounded."

"When we immunize the population against COVID-19, GBS (and other neurological illnesses) will occur, by chance alone, in the weeks after immunization, the window for a normal response to the vaccine,” added corresponding author Michael Lunn, MBBS, PhD. "These cases may cause concern in patients, politicians, and regulators and stoke anti-vaccination concerns, even though it is likely that most, if not all of the cases, will be associated with vaccination by chance alone”

Lunn suggested that cases of such a severe illness could result in a “knee jerk” reaction to end a vaccination program but argued against that unless there is a statistically demonstrated link proven through careful monitoring, noting, “We must accept small risks with any vaccination program on this scale, and these are far lower than the risk from COVID infection."