PMC:7445716 / 1828-4472 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7445716","sourcedb":"PMC","sourceid":"7445716","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7445716","text":"Introduction\nCoronavirus disease 2019 (COVID-19) pandemic has rapidly spread around the world from Jan-2020, with more than 14,000,000 cases confirmed so far [1]. Although primary affecting the respiratory system, central and peripheral neurological manifestations associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been increasingly reported [2–4]. In detail, several pieces of evidence suggested an association between SARS-CoV-2 infection and the development of Guillain–Barré Syndrome (GBS) [5–56].\nGBS represents the most common cause of acute flaccid paralysis [57]. The classic form is an immune-mediated acute-onset demyelinating polyradiculoneuropathy (acute inflammatory demyelinating polyneuropathy—AIDP) typically presenting with ascending weakness, loss of deep tendon reflexes, and sensory deficits. Diagnosis of GBS relies on the results of clinical, electrophysiological, and cerebrospinal fluid (CSF) examinations (classically albuminocytological dissociation) [57–59]. The clinical spectrum of GBS encompasses a classic sensorimotor form, Miller Fisher syndrome (MFS), bilateral facial palsy with paraesthesia, pure motor, pure sensory, paraparetic, pharyngeal–cervical–brachial variants, polyneuritis cranialis (GBS–MFS overlap), and Bickerstaff brainstem encephalitis [57–60]. As regard electrophysiological features, three main subtypes are recognized: AIDP, acute motor axonal neuropathy (AMAN), and acute motor sensory axonal neuropathy (AMSAN) [57, 58, 61]. Peripheral nerve damage is thought to be provoked by an aberrant immune response to infections, in some cases driven by the production of autoreactive antibodies (anti-ganglioside antibodies) [57–59]. Potential triggering pathogens include both viruses [e.g., cytomegalovirus (CMV), Epstein–Barr virus (EBV), influenza virus, hepatitis E virus, and Zika virus] and bacteria (e.g., Campylobacter Jejuni, Mycoplasma Pneumoniae) [57, 58, 62]. However, a relationship with other events has been also described (e.g., vaccinations, surgery, administration of checkpoint inhibitors, and malignancy) [57, 58]. Given that a potential causal association with beta-coronaviruses [Middle East Respiratory Syndrome (MERS-CoV)] has already been speculated, the relationship between COVID-19 and GBS deserves undoubtedly further attention [63, 64].\nWith this background, our systematic review aimed to provide a comprehensive and updated overview of all case reports and series of COVID-19-related GBS to identify predominant clinical, laboratory, and neurophysiological patterns and to discuss the possible underlying pathophysiology.","divisions":[{"label":"title","span":{"begin":0,"end":12}},{"label":"p","span":{"begin":13,"end":543}},{"label":"p","span":{"begin":544,"end":2357}}],"tracks":[{"project":"LitCovid-PD-FMA-UBERON","denotations":[{"id":"T6","span":{"begin":194,"end":212},"obj":"Body_part"},{"id":"T7","span":{"begin":816,"end":822},"obj":"Body_part"},{"id":"T8","span":{"begin":933,"end":952},"obj":"Body_part"},{"id":"T9","span":{"begin":954,"end":957},"obj":"Body_part"},{"id":"T10","span":{"begin":1306,"end":1315},"obj":"Body_part"},{"id":"T11","span":{"begin":1523,"end":1539},"obj":"Body_part"},{"id":"T12","span":{"begin":1691,"end":1702},"obj":"Body_part"}],"attributes":[{"id":"A6","pred":"fma_id","subj":"T6","obj":"http://purl.org/sig/ont/fma/fma7158"},{"id":"A7","pred":"fma_id","subj":"T7","obj":"http://purl.org/sig/ont/fma/fma9721"},{"id":"A8","pred":"fma_id","subj":"T8","obj":"http://purl.org/sig/ont/fma/fma20935"},{"id":"A9","pred":"fma_id","subj":"T9","obj":"http://purl.org/sig/ont/fma/fma20935"},{"id":"A10","pred":"fma_id","subj":"T10","obj":"http://purl.org/sig/ont/fma/fma79876"},{"id":"A11","pred":"fma_id","subj":"T11","obj":"http://purl.org/sig/ont/fma/fma65239"},{"id":"A12","pred":"fma_id","subj":"T12","obj":"http://purl.org/sig/ont/fma/fma82816"},{"subj":"T6","pred":"source","obj":"LitCovid-PD-FMA-UBERON"},{"subj":"T7","pred":"source","obj":"LitCovid-PD-FMA-UBERON"},{"subj":"T8","pred":"source","obj":"LitCovid-PD-FMA-UBERON"},{"subj":"T9","pred":"source","obj":"LitCovid-PD-FMA-UBERON"},{"subj":"T10","pred":"source","obj":"LitCovid-PD-FMA-UBERON"},{"subj":"T11","pred":"source","obj":"LitCovid-PD-FMA-UBERON"},{"subj":"T12","pred":"source","obj":"LitCovid-PD-FMA-UBERON"}]},{"project":"LitCovid-PD-UBERON","denotations":[{"id":"T2","span":{"begin":194,"end":212},"obj":"Body_part"},{"id":"T3","span":{"begin":816,"end":822},"obj":"Body_part"},{"id":"T4","span":{"begin":933,"end":952},"obj":"Body_part"},{"id":"T5","span":{"begin":1306,"end":1315},"obj":"Body_part"},{"id":"T6","span":{"begin":1534,"end":1539},"obj":"Body_part"}],"attributes":[{"id":"A2","pred":"uberon_id","subj":"T2","obj":"http://purl.obolibrary.org/obo/UBERON_0001004"},{"id":"A3","pred":"uberon_id","subj":"T3","obj":"http://purl.obolibrary.org/obo/UBERON_0000043"},{"id":"A4","pred":"uberon_id","subj":"T4","obj":"http://purl.obolibrary.org/obo/UBERON_0001359"},{"id":"A5","pred":"uberon_id","subj":"T5","obj":"http://purl.obolibrary.org/obo/UBERON_0002298"},{"id":"A6","pred":"uberon_id","subj":"T6","obj":"http://purl.obolibrary.org/obo/UBERON_0001021"},{"subj":"T2","pred":"source","obj":"LitCovid-PD-UBERON"},{"subj":"T3","pred":"source","obj":"LitCovid-PD-UBERON"},{"subj":"T4","pred":"source","obj":"LitCovid-PD-UBERON"},{"subj":"T5","pred":"source","obj":"LitCovid-PD-UBERON"},{"subj":"T6","pred":"source","obj":"LitCovid-PD-UBERON"}]},{"project":"LitCovid-PD-MONDO","denotations":[{"id":"T25","span":{"begin":13,"end":37},"obj":"Disease"},{"id":"T26","span":{"begin":39,"end":47},"obj":"Disease"},{"id":"T27","span":{"begin":281,"end":328},"obj":"Disease"},{"id":"T28","span":{"begin":281,"end":314},"obj":"Disease"},{"id":"T29","span":{"begin":330,"end":338},"obj":"Disease"},{"id":"T30","span":{"begin":342,"end":351},"obj":"Disease"},{"id":"T31","span":{"begin":462,"end":470},"obj":"Disease"},{"id":"T32","span":{"begin":473,"end":482},"obj":"Disease"},{"id":"T33","span":{"begin":506,"end":529},"obj":"Disease"},{"id":"T34","span":{"begin":531,"end":534},"obj":"Disease"},{"id":"T35","span":{"begin":544,"end":547},"obj":"Disease"},{"id":"T36","span":{"begin":679,"end":701},"obj":"Disease"},{"id":"T37","span":{"begin":703,"end":750},"obj":"Disease"},{"id":"T38","span":{"begin":722,"end":750},"obj":"Disease"},{"id":"T39","span":{"begin":736,"end":750},"obj":"Disease"},{"id":"T40","span":{"begin":751,"end":755},"obj":"Disease"},{"id":"T41","span":{"begin":868,"end":871},"obj":"Disease"},{"id":"T42","span":{"begin":1053,"end":1056},"obj":"Disease"},{"id":"T43","span":{"begin":1098,"end":1120},"obj":"Disease"},{"id":"T44","span":{"begin":1122,"end":1125},"obj":"Disease"},{"id":"T47","span":{"begin":1138,"end":1150},"obj":"Disease"},{"id":"T49","span":{"begin":1145,"end":1150},"obj":"Disease"},{"id":"T50","span":{"begin":1248,"end":1260},"obj":"Disease"},{"id":"T51","span":{"begin":1272,"end":1275},"obj":"Disease"},{"id":"T52","span":{"begin":1276,"end":1279},"obj":"Disease"},{"id":"T55","span":{"begin":1294,"end":1328},"obj":"Disease"},{"id":"T56","span":{"begin":1316,"end":1328},"obj":"Disease"},{"id":"T57","span":{"begin":1415,"end":1419},"obj":"Disease"},{"id":"T58","span":{"begin":1421,"end":1450},"obj":"Disease"},{"id":"T59","span":{"begin":1433,"end":1450},"obj":"Disease"},{"id":"T60","span":{"begin":1440,"end":1450},"obj":"Disease"},{"id":"T61","span":{"begin":1452,"end":1456},"obj":"Disease"},{"id":"T62","span":{"begin":1463,"end":1500},"obj":"Disease"},{"id":"T63","span":{"begin":1483,"end":1500},"obj":"Disease"},{"id":"T64","span":{"begin":14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