tetano
Editor, Senior Moderator
J Peripher Nerv Syst
. 2020 Oct 28.
doi: 10.1111/jns.12419. Online ahead of print.
Guillain-Barr? syndrome associated with SARS-CoV-2 infection: a systematic review and individual participant data meta-analysis
Imran Hasan[SUP] 1 [/SUP], K M Saif-Ur-Rahman[SUP] 2 3 [/SUP], Shoma Hayat[SUP] 1 [/SUP], Nowshin Papri[SUP] 1 4 [/SUP], Israt Jahan[SUP] 1 [/SUP], Rufydha Azam[SUP] 1 [/SUP], Gulshan Ara[SUP] 5 [/SUP], Zhahirul Islam[SUP] 1 [/SUP]
Affiliations
Abstract
Background and aims: Several published reports have described a possible association between Guillain-Barr? syndrome (GBS) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This systematic review aimed to summarize and meta-analyze the salient features and prognosis of SARS-CoV-2-associated GBS.
Methods: We searched the PubMed (Medline), Web of Science and Cochrane databases for articles published between January 1[SUP]st[/SUP] and August 5[SUP]th[/SUP] 2020 using SARS-CoV-2 and GBS-related keywords. Data on sociodemographic characteristics, antecedent symptoms, clinical, serological and electrophysiological features, and hospital outcomes were recorded.
Results: We included 45 articles from 16 countries reporting 61 patients with SARS-CoV-2-associated GBS. Most (97.7%) articles were from high- and upper-middle-income countries. Forty-two (68.9%) of the patients were male; median (interquartile range) age was 57 (49-70) years. Reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2 was positive in 90.2% of patients. One report of SARS-CoV-2-associated familial GBS was found which affected a father and daughter of a family. Albuminocytological dissociation in cerebrospinal fluid was found in 80.8% of patients. The majority of patients (75.5%) had a demyelinating subtype of GBS. Intravenous immunoglobulin (IVIg) and plasmapheresis were given to 92.7% and 7.3% of patients, respectively. Around two-thirds (65.3%) of patients had a good outcome (GBS-disability score ≤ 2) on discharge from hospital. Two patients died in hospital.
Conclusion: SARS-CoV-2-associated GBS mostly resembles the classical presentations of GBS that respond to standard treatments. Extensive surveillance is required in low- and lower-middle-income countries to identify and report similar cases/series. Further large-scale case-control studies are warranted to strengthen the current evidence. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Coronavirus disease; GBS; Guillain-Barr? syndrome; SARS-CoV-.
. 2020 Oct 28.
doi: 10.1111/jns.12419. Online ahead of print.
Guillain-Barr? syndrome associated with SARS-CoV-2 infection: a systematic review and individual participant data meta-analysis
Imran Hasan[SUP] 1 [/SUP], K M Saif-Ur-Rahman[SUP] 2 3 [/SUP], Shoma Hayat[SUP] 1 [/SUP], Nowshin Papri[SUP] 1 4 [/SUP], Israt Jahan[SUP] 1 [/SUP], Rufydha Azam[SUP] 1 [/SUP], Gulshan Ara[SUP] 5 [/SUP], Zhahirul Islam[SUP] 1 [/SUP]
Affiliations
- PMID: 33112450
- DOI: 10.1111/jns.12419
Abstract
Background and aims: Several published reports have described a possible association between Guillain-Barr? syndrome (GBS) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This systematic review aimed to summarize and meta-analyze the salient features and prognosis of SARS-CoV-2-associated GBS.
Methods: We searched the PubMed (Medline), Web of Science and Cochrane databases for articles published between January 1[SUP]st[/SUP] and August 5[SUP]th[/SUP] 2020 using SARS-CoV-2 and GBS-related keywords. Data on sociodemographic characteristics, antecedent symptoms, clinical, serological and electrophysiological features, and hospital outcomes were recorded.
Results: We included 45 articles from 16 countries reporting 61 patients with SARS-CoV-2-associated GBS. Most (97.7%) articles were from high- and upper-middle-income countries. Forty-two (68.9%) of the patients were male; median (interquartile range) age was 57 (49-70) years. Reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2 was positive in 90.2% of patients. One report of SARS-CoV-2-associated familial GBS was found which affected a father and daughter of a family. Albuminocytological dissociation in cerebrospinal fluid was found in 80.8% of patients. The majority of patients (75.5%) had a demyelinating subtype of GBS. Intravenous immunoglobulin (IVIg) and plasmapheresis were given to 92.7% and 7.3% of patients, respectively. Around two-thirds (65.3%) of patients had a good outcome (GBS-disability score ≤ 2) on discharge from hospital. Two patients died in hospital.
Conclusion: SARS-CoV-2-associated GBS mostly resembles the classical presentations of GBS that respond to standard treatments. Extensive surveillance is required in low- and lower-middle-income countries to identify and report similar cases/series. Further large-scale case-control studies are warranted to strengthen the current evidence. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Coronavirus disease; GBS; Guillain-Barr? syndrome; SARS-CoV-.