COVID-19 as a trigger of Guillain-Barré syndrome: A review of the
molecular mechanism
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a
pandemic with serious complications. After the coronavirus disease 2019
(COVID-19), several post-acute COVID-19 syndromes (PACSs) and long-COVID
sequels were reported. PACSs involve many organs, including the nervous,
gustatory, and immune systems. One of the PACSs after SARS-CoV-2
infection and vaccination is Guillain-Barré syndrome (GBS). There is a
lower chance of getting GBS after a SARS-CoV-2 infection compared to
other infections. However, the high prevalence of COVID-19 and severe
complications of GBS, e.g., autonomic dysfunction and respiratory
failure, highlight the importance of post-COVID-19 GBS. It is while
patients with simultaneous COVID-19 and GBS seem to have higher
admission rates to the intensive care unit, and demyelination is more
aggressive in post-COVID-19 GBS patients. SARS-CoV-2 can trigger GBS via
several pathways like direct neurotropism and neurovirulence,
microvascular dysfunction and oxidative stress, immune system
disruption, molecular mimicry, and autoantibody production. This review
discusses the most recent evidence regarding the molecular and cellular
mechanisms of GBS after SARS-CoV-2 infection and vaccination.