COVID-19 Not Associated with Guillain-Barre Syndrome, Research Finds

physical therapist stretching a person's legs

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Key Takeaways

  • Research shows there is not a correlation between COVID-19 and Guillain-Barre syndrome.
  • GBS is a rare autoimmune disorder that mistakenly attacks
    the peripheral nervous system, resulting in muscle weakness and possibly paralysis.
  • A majority of people with GBS recover fully, but may have long-lasting weakness.
  • There is not a known correlation between GBS and the COVID-19 vaccination.

Despite earlier reports claiming a link, researchers from the University College London found no correlation between SARS-CoV-2, the virus that causes COVID-19, and Guillain-Barre Syndrome (GBS), a rare neurologic auto-immune disorder that can be caused by certain viral and bacterial infections.

Their study, published in the journal Brain on December 14, analyzed GBS cases from the UK National Immunoglobulin Database. From March 2020 through May 2020, GBS cases decreased by 40-50% compared to the same months in 2016 through 2019. This suggests the mandated social distancing and lock down measures implemented in the UK helped slow the spread of the bacterial (camplylobacter
) and viral infections that are typically responsible for GBS.

What Is Guillain-Barre Syndrome?

According to the National Institute of Neurological Disorders and Stroke (NINDS), GBS is caused by the immune system erroneously attacking its peripheral nervous system—located outside the brain and spinal cord—resulting in a spectrum of symptoms. These can range from mild short-term weakness to destructive paralysis and even death. Luckily, most people recover fully from GBS, but some may have long-term weakness as a result. 

GBS can affect anyone, but is more prominent in adults, affecting about 1 per 100,000 people a year. GBS is usually triggered by a respiratory or gastrointestinal viral infection, but it remains a mystery why it becomes activated in some people and not others.

GBS Previously Linked to Other Outbreaks

Experts were concerned that COVID-19 might activate GBS in some patients because a high number of GBS cases were linked to the Zika virus that swept through many countries in 2016 ahead of the Summer Olympics in Brazil.

Research from the Centers for Disease Control and Prevention (CDC) does suggest that GBS is strongly associated with Zika because several countries that have experienced Zika outbreaks have also reported an increase in GBS cases. However, only a small number of people with recent Zika infection get GBS. As a result, this correlation is still being actively investigated by the CDC.

COVID-19 Vaccination Safety

As distribution of the COVID-19 vaccination increases, some are concerned that it could trigger GBS in some individuals, but according to past vaccination research, there is not a high association between vaccines and GBS.

In an open letter to Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases (NIAD), the GBS/CIDP Foundation encouraged people to get the COVID-19 vaccine when it becomes available to them, and not to worry about the risk of GBS. To date, there have been no instances of GBS triggered by the COVID-19 vaccine.

The GBS/CIDP states there have only been a few instances where a vaccination has slightly increased GBS cases:

  • The 1976/1977 swine flu vaccine was linked to 1 GBS case per 100,000 vaccines administered
  • Since then, the influenza vaccination has been correlated with 1 GSB case per 1,000,000 vaccines administered

Symptoms of GBS

According to the CDC, symptoms first occur symmetrically (on both sides of the body), usually starting with weakness in the legs. They can rapidly progress to the upper body over hours, days, or weeks. 

The most severe stage of weakness usually occurs two weeks after the onset of symptoms. For 90% of people with GBS, the greatest amount of weakness will occur during the third week. 

The NINDS highlights that in addition to weakness, those diagnosed with GBS might experience:

  • Difficulty with eye muscles and vision
  • Difficulty swallowing, speaking, or chewing
  • Pricking or pins and needles sensations in the hands and feet
  • Pain that can be severe, particularly at night
  • Coordination problems and unsteadiness
  • Abnormal heart beat/rate or blood pressure
  • Problems with digestion and/or bladder control

How Is GBS Treated?

Since the muscles used to breathe can be affected, GBS patients are treated in the intensive care unit (ICU) in case intubation and ventilation is needed.

Currently, there is not a cure for GBS, but studies have shown that symptom severity decreases in patients treated with either plasma exchange (plasmapheresis) or high doses of immunoglobulin therapy (IVIg).

After the acute phase of GBS is resolved, patients are usually transferred to a rehabilitation setting to begin the recovery phase. Physical therapy can help move muscles to prevent atrophy, bed sores, and muscle shortening. Blood thinner injections can help prevent blood clots. Occupational therapy may be scheduled as well.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Keddie S, Pakpoor J, Mousele C. Pipis M, Machado P, Foster M, et al. Epidemiological and cohort study finds no association between COVID-19 and Guillain-Barré syndrome. Brain. Awaa433. doi:10.1093/brain/awaa433

  2. The National Institute of Neurological Disorders and Stroke. Guillain-Barré Syndrome Fact Sheet. March 16, 2020.

  3. Centers for Disease Control and Prevention. Zika and Guillain-Barré Syndrome. May 14, 2019.

  4. Centers for Disease Control and Prevention. Guillain-Barré Syndrome. December 20, 2019.

By Amy Isler, RN, MSN, CSN
Amy Isler, RN, MSN, CSN, is a registered nurse with over six years of patient experience. She is a credentialed school nurse in California.