\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[english]{babel}



\usepackage{float}








\begin{document}

\title{Recombinant protein subunit COVID-19 Vaccine Induced Guillain-Barre
Syndrome in an adolescent: A case report.}



\author[1]{Rachna Rohilla}%
\author[1]{Ashish Kakkar}%
\author[1]{Krishna Divyashree}%
\author[2]{Ritin Mohindra}%
\author[1]{Vikas Suri}%
\affil[1]{Post Graduate Institute of Medical Education and Research}%
\affil[2]{Department of Internal Medicine}%


\vspace{-1em}



  
  \date{May 28, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
Guillain- Barre Syndrome (GBS), an autoimmune neurological disease of
peripheral nerves has been causally associated with COVID-19 vaccination
in adults. However, no such report has been published so far in
children. We describe a 13-year old female child who presented to
emergency department with complaints of bilateral upper limb, lower limb
and truncal weakness over three days following first dose of recombinant
protein subunit COVID-19 vaccine (Corbevax). Clinical examination and
nerve conduction studies showed pure motor axonal polyneuropathy with
absent compound muscle action potential (CMAP) in all sampled nerves of
upper and lower limbs which was consistent with the diagnosis of GBS
after ruling out possible alternative aetiologies. A temporal
association between first dose of protein subunit COVID-19 vaccine
administered a day prior and symptom onset was noted. The causality
assessment using World Health Organization (WHO) tool for adverse event
following immunization (AEFI) assessment indicated vaccine-product
related reaction categorized as A1. Patient's clinical condition
improved after seven sessions of plasmapheresis. The purpose of this
report is to create awareness among the health care professionals about
COVID-19 vaccine induced GBS in children as early diagnosis and
management can be critical in avoiding complications and improving
patient outcomes.%
\end{abstract}%



\sloppy


\textbf{Hosted file}

\verb`Corbevax_GBS_Ver1.2.docx`  available at \url{https://authorea.com/users/488154/articles/572406-recombinant-protein-subunit-covid-19-vaccine-induced-guillain-barre-syndrome-in-an-adolescent-a-case-report}

\selectlanguage{english}
\FloatBarrier
\end{document}

