PhD defence S.E. (Sonja) Leonhard

Dissertation in short:

In the past decades the world confronted several pandemics of emerging infectious diseases, including Zika virus and most recently Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Guillain-Barré syndrome (GBS), a rare and severe disease of the peripheral nerves, is one of the neurological complications reported in relation to these infections.  Patients suffering from GBS can present with a large variety of symptoms, and some become completely paralyzed in the timespan of a few days and need to be mechanically ventilated in the Intensive Care Unit. GBS is thought to be cause by an aberrant immune response to a preceding infection and several different types of infections have been connected to GBS in the past. 

In this thesis I investigated which infections contribute most to the global disease burden of GBS and  whether the type of preceding infection the patient had could help predict the patients’ disease course. Furthermore, I investigated whether new emerging infectious diseases including Zika virus and SARS-CoV-2  were indeed associated with GBS and developed the first international guideline on the management of GBS. 

I found that the type of infection is indeed associated with the specific disease course of GBS and may be of use in future prognostic models of the disease. There is sufficient evidence associating Zika virus infection with the development of GBS, but there is competing evidence related to the association between SARS-CoV-2 and GBS: if there is an association, the risk is likely to be significantly lower than other known triggers.