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J Neuroimmunol . Association of Guillain-Barre syndrome with COVID-19 infection: An updated systematic review

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  • J Neuroimmunol . Association of Guillain-Barre syndrome with COVID-19 infection: An updated systematic review


    J Neuroimmunol


    . 2021 Apr 18;355:577577.
    doi: 10.1016/j.jneuroim.2021.577577. Online ahead of print.
    Association of Guillain-Barre syndrome with COVID-19 infection: An updated systematic review


    Abu Baker Sheikh 1 , Prabal Kumar Chourasia 2 , Nismat Javed 3 , Mehul Kumar Chourasia 4 , Sajid S Suriya 5 , Shubhra Upadhyay 6 , Fatima Ijaz 6 , Suman Pal 6 , Narges Moghimi 5 , Rahul Shekhar 6



    Affiliations

    Abstract

    Objective: The systematic review aimed to determine demographic characteristics, clinical features, lab evaluation, management and complications of the studies focusing on Guillain-Barre syndrome (GBS) as a sequele of novel coronavirus (COVID-19) infection.
    Methods: After protocol registration, PubMed, Web of Science and Cumulative Index to Nursing & Allied Health Literature (CINHAL) databases were searched for relevant articles using MeSH key-words and imported into referencing/review softwares. The data, regarding demographic and clinical characteristics, diagnostic workup and management, was analyzed in International Business Machines (IBM) Statistics SPSS 21. Many statistical tests, such as t-test and the Mann-Whitney U test, were used. P < 0.05 was considered significant.
    Results: We identified 64 relevant articles. The mean age of the patients was 56 ? 16 years; the majority were males (64.9%). Among the neurological findings, paresthesia was the most typical symptom (48.9%). Most of the patients had been diagnosed by reverse transcriptase-polymerase chain reaction (RT-PCR) (69.2%). Two-third of the patients received immunoglobulins (IVIg) (77.7%). Although functions recovered in most patients, there were four patients with facial diplegia during follow-up (4.26%). Acute inflammatory demyelinating polyneuropathy (AIDP) was more likely to be associated with paresis of the lower extremity (p < 0.05) and higher levels of glucose on cerebrospinal fluid (CSF) analysis (p < 0.05). These patients were more likely to receive IVIg (p < 0.05) and develop respiratory insufficiency, subsequently (p < 0.05).
    Conclusions: GBS is being recognized as one of the many presentations of the COVID-19 infection. Although the common form is AIDP that might lead to complications, other variants are possible as well, and more studies are needed to focus on those subvariants.

    Keywords: Acute inflammatory demyelinating polyneuropathy; COVID-19; Guillain-Barre syndrome; Miller-Fisher syndrome.

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