Although Guillain-Barré syndrome is rare, a marked increase in incidence was observed during the 2016 Zika outbreak in the Americas, with no direct causal relationship being apparent in all cases. Cases of febrile exanthematous disease and acute flaccid paralysis were reviewed during the period from 1 August to 15 December, 2016; clinical and biochemical assessment was performed for each case to identify Zika-related Guillain-Barré syndrome. During the study period, we identified 8 patients (6 men and 2 women) with Zika-related Guillain-Barré syndrome, with the most affected age group being 50-59 years. The highest incidence was in the month of September, with 7 cases. The most frequent symptoms were rash and conjunctivitis, followed by fever. The most common presentation was symmetrical ascending paralysis, present in 7 cases. Cranial nerve VII was the most frequently involved nerve. Only 2 patients presented albuminocytologic dissociation. RT-PCR returned negative results for Zika virus in all patients. All patients received intravenous immunoglobulin and all had a good prognosis. None warranted mechanical ventilation. No deaths were recorded. The cumulative incidence rate was 3.9%, monthly incidence was between 0.04 and 2 cases/month. Cases of Guillain-Barré syndrome increased during the Zika outbreak, with an increase in incidence and number of cases per month; however, a direct causal relationship between the 2 conditions could not be demonstrated.

Determine whether the levels of glycated hemoglobin (HbA1c) measured on admission to the intensive care unit (ICU) are associated with mortality in patients with severe SARS-CoV-2 pneumonia with invasive mechanical ventilation. Cohort study, retrospective, observational. A single center. ICU of a second-level care hospital. Severe SARS-CoV-2 pneumonia confirmed with IMV since admission to the ICU. none. A total of 56 patients with severe pneumonia, confirmed with SARS-CoV-2, all with IMV. The group with HbA1c 500 U/L, OR 3.65 (95% CI 1.18–11.29), HbA1c ≥6.5%, OR 3.12 (95% CI 1.01–9.6), SAH, OR 3.12 (95% CI 1.01–9.5), use of vasopressor, OR 0.2 (95% CI 0.05–0.73), diabetes was not statistically significant. The 28-day probability of survival in patients with severe SARS-CoV-2 pneumonia with IMV in the ICU is lower when the HbA1c level is ≥6.5% on admission.

After Zika virus outbreak and the increase in the incidence of Guillain-Barre syndrome (GBS), the causal relationship has been studied, however a full etiological correlation has not been found. From January 1 to December 31, 2017, patients with GBS were included. In addition to the basic serologies, enterovirus, herpes, Campylobacter, hepatitis B and C, TORCH, HIV, Brucella and Salmonella were requested. Cohort of seven male patients. Five patients analyzed cerebrospinal fluid reporting normal; all of them underwent brain scan, reporting normal. Neuroconduction was performed, resulting in acute inflammatory demyelinating polyneuropathy in four cases and acute motor axonal neuropathy in one case. All received intravenous immunoglobulins, five cases had a good prognosis and two deaths. No positive cases were reported to Zika virus. A positive case was reported to dengue and another to chikungunya. Five positive cases were reported to Campylobacter. One case positive to enterovirus. Dengue + Campylobacter coinfections were reported in one case and chikungunya + Campylobacter in another case. The present cohort shows that it was not possible to establish a causal relationship between GBS and Zika virus, but other viral and bacterial causal agents were identified, such as dengue, chikungunya and enterovirus, with the identification of Campylobacter cases even more remarkable.