When Our Body Immune System Attacks Our Nerves
Covid-19 and it's vaccines are linked to Guillain-Barre Syndrome.
Our normal immune system usually only attacks invading organisms. But in Guillain-Barre Syndrome (GBS), our immune system begins to attack the nerves. In Acute inflammatory demyelinating polyradiculoneuropathy (AIDP), one of the GBS in US, the nerves' protective covering (myelin sheath) is damaged. The damage prevents nerves from transmitting signals to your brain, causing weakness, numbness or paralysis.
The central nervous system is protected by a highly complex brain barrier system, which is the first line of defense against virus invasion. The brain barrier is composed of the blood-brain barrier, blood-cerebrospinal fluid barrier, and brain-cerebrospinal fluid barrier. The blood-brain barrier has a maximum surface area that can be used for communication between the brain and blood. It consists of cerebral capillary endothelial cells, extracellular matrix, and astrocyte podocytes. The blood-cerebrospinal fluid barrier is located in the choroid plexus of the ventricle of the brain. The epithelial cells of the choroid plexus are mainly responsible for the barrier function of the blood-cerebrospinal fluid barrier. The blood-brain barrier and the blood-cerebrospinal fluid barrier can inhibit paracellular diffusion, protect the central nervous system from the influence of the constantly changing blood environment, infections and toxins, and are crucial for maintaining the homeostasis of the central nervous system.
GBS in Covid-19 Patients
The neurological diseases possibly caused by SARS-CoV-2 can be divided into three major categories:
- Nervous system consequences of related lung and systemic diseases, such as cerebrovascular disease;
- The virus directly invades the central nervous system, such as encephalitis disease
- Potential immune-mediated complications after infection, such as Guillain-Barre syndrome (GBS) and other types of demyelinating diseases
It is considered a demyelinating disease because the lesions mainly affect myelin in the peripheral nerves, leading to paresis (mild paralysis), muscle weakness, and even bilateral ascending paralysis. If nerve damage reaches the diaphragmatic nerves, the patient may present respiratory symptoms ranging from mild respiratory failure to the need for invasive ventilatory support. Unfortunately, GBS is incurable; treatment focuses on symptom management and ventilatory support.
SARS-CoV-2 may cause neurological damage include the binding of the virus to ACE2 in the blood-brain barrier (BBB), enabling it to enter the central nervous system, as well as the existence of haematogenous (originating in or carried by the blood), transcribrial, and neuronal retrograde dissemination pathways.
GBS is one of the frequent neurological complications associated with COVID-19. The mean time from COVID‐19 symptoms to GBS symptoms was 11 days. Some reported the first neurological manifestations presented between 5 and 21 days after onset of COVID-19 symptoms. The clinical presentation and severity of these GBS cases was similar to those with non‐COVID‐19 GBS. The autopsy of Covid-19 patients showed brain edema (swelling) and partial degeneration of neurons.
Some observations stated that viral particles gradually accumulated within the neuronal cells of the brain organs from 6 to 72 h after SARS-CoV-2 infection, indicating that the virus replicated actively and effectively in the neuronal cells within the first few days of infection. However, some groups observed that viral infection did not replicate effectively in the first few days and suggested that the central nervous system might serve as a long-term reservoir of the virus.
Some viruses were reported to trigger the GB syndrome i.g. influenza virus, cytomegalovirus, Eipstein Barr virus, Zika, Hepatitis, HIV, and SARS-CoV-2. Most people recover from GB syndrome, the mortality rate is 4% to 7%, between 60-80% of patients are able to walk at six months.
The most common symptoms appearing before onset of GBS were ageusia (complete loss of taste function of tongue) and hyposmia (decrease sense of smell and taste); COVID-19–associated symptoms, such as pneumonia, were also observed to be more severe. Assini et al. regarded the differences in the manifestations of GBS before and after the pandemic. According to them, impairment of several cranial nerves in association with a demyelinating peripheral neuropathy is a very infrequent characteristic that only affected 5% of previously reported cases; however, in the context of COVID-19, cranial nerve involvement was observed in 47% of the patients included in this review, and represents a distinctive characteristic of the cases associated with the disease.
GBS in Covid-19 Vaccines
In some countries where Sinovac was shipped, rarely hard to find any ADE effects of this vaccine. In Indonesia happened a 31 years old female was diagnosed with GBS. Ten minutes after she took the vaccine, she started to feel dizzy, nausea, limp. When the jab was taken, there was blood gushed out. The hospital said it was GBS with symptoms : paralysis and visual disturbances. Nevertheless, the authority rejected it as an ADE of Covid vaccination. Johnson and Johnson (J&J) trial found that one case in the vaccine arm developed GBS and one case in placebo too. But the researchers said that these were coincidence.
I believe there are still GBS cases due to the Covid vaccines because many authorities neglected the symptomps as GBS. The second purpose of this writing is to introduce GBS as the ADE after Covid vaccination so the readers may educate people who are unaware of the GBS symptomps post-Covid-vaccination.
Signs and symptoms of Guillain-Barre syndrome may include:
- Prickling, pins and needles sensations in your fingers, toes, ankles or wrists
- Weakness in your legs that spreads to your upper body
- Unsteady walking or inability to walk or climb stairs
- Difficulty with facial movements, including speaking, chewing or swallowing
- Double vision or inability to move eyes
- Severe pain that may feel achy, shooting or cramplike and may be worse at night
- Difficulty with bladder control or bowel function
- Rapid heart rate
- Low or high blood pressure
- Difficulty breathing
Sources:
https://amp.kompas.com/nasional/read/2021/05/03/11392471/guru-lumpuh-usai-ikut-vaksinasi-covid-19-komnas-kipi-didiagnosis-alami
https://www.elsevier.es/en-revista-neurologia-english-edition--495-avance-resumen-relation-between-covid-19-guillain-barre-syndrome-S2173580820302145
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7405390/
https://www.dovepress.com/novel-coronavirus-covid-19-associated-guillainndashbarrersquo-syndrome-peer-reviewed-fulltext-article-IMCRJ#
https://www.frontiersin.org/articles/10.3389/fneur.2020.592888/full
https://www.aan.com/PressRoom/Home/PressRelease/4878
https://en.m.wikipedia.org/wiki/Paresthesia#:~:text=Paresthesia%20is%20an%20abnormal%20sensation,dozens%20of%20possible%20underlying%20causes.
https://www.neurologylive.com/view/guillain-barre-syndrome-covid-vaccine-trial-johnson-johnson
Pictures:
BBB taken from https://www.rit.edu/spotlights/blood-brain-barrier
Damaged Myelin taken from mayoclinic.org.