Abstract:
COVID-19 Virus has affected the world in many ways, resulting in several
challenges. It has resulted in high rates of morbidity and mortality.
Efforts have been made to study the nature of the disease and discover a
new treatment to help decrease those rates. COVID 19 vaccines were
introduced recently\sout, with a variable degree of immunogenicity and
safety.
We report a 61-year-old man who developed GBS within 4 days of receiving
the Moderna SARS-CoV-2 vaccine. Patient presented with 3-day history of,
distal more than proximal, upper extremity progressive weakness four
days following receiving the second dose mRNA-based vaccine. Common
infectious triggers of Guillain-Barre syndrome (GBS) were ruled out. His
clinical picture, CSF analysis and electrodiagnostic testing were
consistent with acute demyelinating polyneuropathy. His clinical
condition significantly improved after five days course of intravenous
immunoglobulin (IVIG).
COVID-19 vaccines have been tested in large, randomized controlled
trials. The vaccines have shown a high level of efficacy and safety
across all populations. However, they can result in different side
effects, as is the case with all other vaccines. Neurological side
effects can occur following COVID-19 vaccines. However, their frequency
is not well studied yet. One of those side effects is the development of
Guillain barre syndrome. The frequency of its occurrence is still not
precise, and many other studies are needed to clarify its incidence
further. The temporal relationship between COVID-19 vaccination and GBS
development in this case was suggestive of a vaccine-induced cause, and
the clinical implications of this association warrant further research.
Introduction :
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Is a
newly emerging disease entity first reported in Wuhan, China, in
December 2019. it led to high morbidity and mortality rates, affecting
the world on the social, psychological, and financial aspects (1). its
presentations are widely variable depending on the system involved. The
main presenting symptoms are respiratory, ranging from asymptomatic to a
more severe lower respiratory tract infection, acute respiratory
distress syndrome (ARDS), and in more severe cases, death. However, it
can also infect the central nervous, cardiovascular, and
gastrointestinal systems (2). Numerous treatments have been utilized for
treating it, and the evidence on how to treat it is growing daily. (3)
since its emergence, efforts have been put to find a vaccine that would
halt the progression of the pandemic. In December 2020, the first
COVID-19 vaccines were successfully announced with promising results and
were approved for use after an emergency authorization by FDA. (4) Side
effects secondary to these vaccines were variable, and further studies
are needed to establish their safety. some of the side effects described
are myalgia, fever, and headache. Other side effects were reactivation
of the COVID-19 and ARDS (5). neurological side effects are rare but
have been described (6). We hereby report a case that we encountered
after an mRNA vaccine and was found to have features of acute
demyelinating polyneuropathy as found by nerve conduction studies.