Concomitant Guillain–Barré Syndrome and COVID-19: A Meta-Analysis of Cases
<i>Background and Objectives</i>: Recent findings demonstrate that the transmigration of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) to the nervous system implicates severe neurotropic pathologies, including the onset of the rare disease called Guillain–Barré syndrome (G...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-12-01
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| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/58/12/1835 |
| Summary: | <i>Background and Objectives</i>: Recent findings demonstrate that the transmigration of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) to the nervous system implicates severe neurotropic pathologies, including the onset of the rare disease called Guillain–Barré syndrome (GBS) which is characterized by immune-mediated polyneuropathy. This study aimed to identify the predisposing factors and the clinical features of coronavirus disease 2019 (COVID-19)-induced GBS. <i>Materials and Methods</i>: We have performed an analysis of 147 cases. A systematic review of the published research work was performed per the PRISMA statement to obtain individual participant data (IPD) for the meta-analysis. The search was conducted through PubMed, using the combined search terms “Guillain–Barré syndrome” and “COVID-19”. All case reports and series in the English language with accessed full text were included in the search. <i>Results</i>: A systematic database search led to the retrieval of 112 peer-reviewed articles published between 1 April 2020, and 8 February 2022. The articles comprised 16 case series and 96 case reports containing IPD for 147 patients. Our findings showed that 77.6% of all cases were 40 years or older. Males comprised most of the cases (65.3%; <i>n</i> = 96). The intensive care unit (ICU) admission was 44.9%, and the need for mechanical ventilation (MV) was 38.1%. The patients presented with hyporeflexia or areflexia (84.4%; <i>n</i> = 124), lower limb strength and sensation impairment (93.2%; <i>n</i> = 138), upper limb strength and sensation impairment (85.7; <i>n</i> = 126), and somatic sensation impairment (72.8%; <i>n</i> = 107). The patients presented with increased cerebral spinal fluid (CSF) protein levels (92%; <i>n</i> = 92) and the presence of CSF albuminocytological dissociation (83.5%; <i>n</i> = 71). The most common variant of GBS observed was acute inflammatory demyelinating polyneuropathy (AIDP). We found that predisposing factors concomitant with COVID-19 and GBS were male gender and older age. Among the cases, patient mortality was 10.9%. <i>Conclusions</i>: A gap of knowledge exists regarding the complete spectrum of clinical characteristics of COVID-19-related GBS. Recent findings suggest that SARS-CoV-2 triggers GBS, as it follows a similar para-infectious pattern as the other viral agents contributing to the onset of GBS. |
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| ISSN: | 1010-660X 1648-9144 |