A NEW study finds that respiratory syncytial virus (RSV) infection is associated with a rare but elevated risk of Guillain-Barré syndrome (GBS) in older adults, particularly those aged ≥75 years.
RSV and Older Adults’ Neurological Risk
Guillain-Barré syndrome is a rare autoimmune disorder often triggered by viral infections such as influenza or SARS-CoV-2. Until now, the association between RSV—a common cause of respiratory illness in older adults—and GBS had not been systematically studied. Understanding this link is critical, as RSV infections are increasingly recognised as significant contributors to morbidity in adults over 65.
Large Medicare Study Evaluates Incidence of Guillain-Barré Syndrome
Researchers analysed US Medicare claims data from 2011 to 2024, including 452,471 adults aged ≥65 with medically attended RSV. Using a self-controlled case series design, the study compared GBS incidence 1–42 days post-RSV with control periods 180–22 days before and 43–180 days after RSV infection. Conditional Poisson regression adjusted for seasonality and viral activity, allowing precise estimation of RSV-related GBS risk.
RSV Linked to Elevated Risk of Guillain-Barré Syndrome
Results showed fewer than 11 GBS cases during the risk period versus 34 in control periods. The adjusted incidence rate ratio (IRR) for GBS following RSV was 2.11 (95% CI: 1.01–4.37), rising to 2.59 (1.17–5.73) after ICD-10 code adoption. Patients aged ≥75 experienced a particularly pronounced increase in risk (IRR: 3.98; 95% CI: 1.45–10.91). Sensitivity analyses confirmed these findings, supporting RSV as a rare but relevant trigger for GBS in older adults.
Takeaways
This study highlights RSV as a pathogen that can rarely precipitate Guillain-Barré syndrome, especially in older adults. Clinicians should consider recent RSV infection in differential diagnosis of GBS and monitor high-risk populations closely.
Reference
Liang C et al. Estimating risk of Guillain-Barré syndrome in US Medicare-enrolled older adults following medically attended respiratory syncytial virus disease: a self-controlled case series analysis. Clin Infect Dis. 2025; DOI:10.1093/cid/ciaf621.
