tetano
Editor, Senior Moderator
J Chin Med Assoc
. 2025 May 30.
doi: 10.1097/JCMA.0000000000001251. Online ahead of print. Incidence and characteristics of Guillain-Barré syndrome in Taiwan before and during the COVID-19 pandemic: A 12-year single-center experience
Yu-Hsin Chen[SUP] 1 2 [/SUP], Kuan-Lin Lai[SUP] 1 3 [/SUP], Yi-Chung Lee[SUP] 1 3 4 [/SUP], Yi-Chu Liao[SUP] 1 3 4 [/SUP]
Affiliations
Background: There is substantial regional disparity in the presentation of Guillain-Barré syndrome (GBS), and coronavirus disease 2019 (COVID-19) possibly influences the development of GBS, but the association remains uncertain. This study aimed to investigate the incidence of GBS before and during the COVID-19 pandemic and delineate the clinical profile of GBS in Taiwanese patients.
Methods: Medical records of 185 ascertained GBS cases at Taipei Veterans General Hospital between 2011 and 2022 were reviewed. Patients were analyzed based on age, clinical subtypes, and electrophysiological findings. A multivariable ordinal logistic regression was conducted to identify factors related to outcomes measured by the GBS disability scale (GBS-DS), which ranges from 0 to 6, with higher scores indicating greater disability.
Results: The single center incidence (SCI) of GBS, defined as the number of GBS cases relative to the total number of outpatient and emergency department visits per year, remained stable during the COVID-19 pandemic (14.3 cases per year) compared to the pre-pandemic period (15.8 cases per year). COVID-19 infection or vaccination was reported as a preceding event in six cases, five of which had good outcomes (GBS-DS≤2). In our cohort, 12% were diagnosed with Miller Fisher syndrome (MFS), 13% had GBS/MFS overlap, and the remaining patients had typical GBS. One-third had axonal GBS, associated with significantly worse outcomes compared to demyelinating GBS. The overall mortality rate was 1.1%. Old age, low Medical Research Council sum score, ventilator dependency, and autonomic dysfunction were independent predictors of high GBS-DS scores.
Conclusion: This single-center study found no increase in GBS occurrence during the COVID-19 pandemic. In Taiwan, GBS is characterized by a higher occurrence of MFS and GBS/MFS overlap and more frequent axonal GBS, highlighting geographical variations in GBS features between Asian and Western countries.
Keywords: COVID-19; Guillain–Barré Syndrome; Miller Fisher Syndrome; Vaccines.
. 2025 May 30.
doi: 10.1097/JCMA.0000000000001251. Online ahead of print. Incidence and characteristics of Guillain-Barré syndrome in Taiwan before and during the COVID-19 pandemic: A 12-year single-center experience
Yu-Hsin Chen[SUP] 1 2 [/SUP], Kuan-Lin Lai[SUP] 1 3 [/SUP], Yi-Chung Lee[SUP] 1 3 4 [/SUP], Yi-Chu Liao[SUP] 1 3 4 [/SUP]
Affiliations
- PMID: 40442888
- DOI: 10.1097/JCMA.0000000000001251
Background: There is substantial regional disparity in the presentation of Guillain-Barré syndrome (GBS), and coronavirus disease 2019 (COVID-19) possibly influences the development of GBS, but the association remains uncertain. This study aimed to investigate the incidence of GBS before and during the COVID-19 pandemic and delineate the clinical profile of GBS in Taiwanese patients.
Methods: Medical records of 185 ascertained GBS cases at Taipei Veterans General Hospital between 2011 and 2022 were reviewed. Patients were analyzed based on age, clinical subtypes, and electrophysiological findings. A multivariable ordinal logistic regression was conducted to identify factors related to outcomes measured by the GBS disability scale (GBS-DS), which ranges from 0 to 6, with higher scores indicating greater disability.
Results: The single center incidence (SCI) of GBS, defined as the number of GBS cases relative to the total number of outpatient and emergency department visits per year, remained stable during the COVID-19 pandemic (14.3 cases per year) compared to the pre-pandemic period (15.8 cases per year). COVID-19 infection or vaccination was reported as a preceding event in six cases, five of which had good outcomes (GBS-DS≤2). In our cohort, 12% were diagnosed with Miller Fisher syndrome (MFS), 13% had GBS/MFS overlap, and the remaining patients had typical GBS. One-third had axonal GBS, associated with significantly worse outcomes compared to demyelinating GBS. The overall mortality rate was 1.1%. Old age, low Medical Research Council sum score, ventilator dependency, and autonomic dysfunction were independent predictors of high GBS-DS scores.
Conclusion: This single-center study found no increase in GBS occurrence during the COVID-19 pandemic. In Taiwan, GBS is characterized by a higher occurrence of MFS and GBS/MFS overlap and more frequent axonal GBS, highlighting geographical variations in GBS features between Asian and Western countries.
Keywords: COVID-19; Guillain–Barré Syndrome; Miller Fisher Syndrome; Vaccines.