tetano
Editor, Senior Moderator
Eur J Neurol
. 2021 Apr 9.
doi: 10.1111/ene.14860. Online ahead of print.
Prevalence, clinical characteristics and outcomes of Guillain-Barr? syndrome spectrum associated with COVID-19: a systematic review and meta-analysis
Lina Palaiodimou[SUP] 1 [/SUP], Maria-Ioanna Stefanou[SUP] 1 [/SUP], Aristeidis H Katsanos[SUP] 1 2 [/SUP], Paraskevi C Fragkou[SUP] 3 [/SUP], Marianna Papadopoulou[SUP] 1 4 [/SUP], Christos Moschovos[SUP] 1 [/SUP], Ioannis Michopoulos[SUP] 5 [/SUP], Panagiotis Kokotis[SUP] 6 [/SUP], Christos Bakirtzis[SUP] 7 [/SUP], Androniki Naska[SUP] 8 [/SUP], Theodoros I Vassilakopoulos[SUP] 9 [/SUP], Elisabeth Chroni[SUP] 10 [/SUP], Sotirios Tsiodras[SUP] 3 11 [/SUP], Georgios Tsivgoulis[SUP] 1 12 [/SUP]
Affiliations
Abstract
Background: Mounting evidence supports an association between Guillain-Barr? syndrome spectrum (GBSs) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. However, GBSs in the setting of coronavirus disease-2019 (COVID-19) remains poorly characterized, while GBSs prevalence among COVID-19 patients has not been previously systematically evaluated using a meta-analytical approach.
Methods: We performed a systematic review and meta-analysis of observational cohort and case-series studies reporting on the occurrence, clinical characteristics and outcomes of patients with COVID-19-associated GBSs. A random-effects model was used to calculate pooled estimates and odds ratios (ORs) with corresponding 95% confidence intervals (CIs), when comparing to non-COVID-19, contemporary or historical GBSs patients.
Results: We identified 18 eligible studies (11 cohorts, 7 case-series) including a total of 136,746 COVID-19 patients. Among COVID-19 patients, including hospitalized and non-hospitalized cases, the pooled GBSs prevalence was 0.15? (95%CI:0-0.49?; I[SUP]2[/SUP] =96%). Compared to non-infected contemporary or historical controls, patients with SARS-CoV-2 infection had increased odds for demyelinating GBSs subtypes (OR=3.27; 95%CI: 1.32-8.09; I[SUP]2[/SUP] =0%). In SARS-CoV-2 infected patients, olfactory or concomitant cranial nerve involvement was noted in 41.4% (95%CI:3.5-60.4%; I[SUP]2[/SUP] =46%) and 42.8% (95%CI:32.8-53%; I[SUP]2[/SUP] =0%) of the patients, respectively. Clinical outcomes including in-hospital mortality were comparable between COVID-19 GBSs patients and non-infected contemporary or historical GBSs controls.
Conclusions: GBSs prevalence was estimated at 15 cases per 100,000 SARS-CoV-2 infections. COVID-19 appears to be associated with an increased likelihood of GBSs and with demyelinating GBSs variants in particular.
Keywords: COVID-19; Guillain-Barr? syndrome; acute inflammatory demyelinating polyneuropathy; mortality; prevalence.
. 2021 Apr 9.
doi: 10.1111/ene.14860. Online ahead of print.
Prevalence, clinical characteristics and outcomes of Guillain-Barr? syndrome spectrum associated with COVID-19: a systematic review and meta-analysis
Lina Palaiodimou[SUP] 1 [/SUP], Maria-Ioanna Stefanou[SUP] 1 [/SUP], Aristeidis H Katsanos[SUP] 1 2 [/SUP], Paraskevi C Fragkou[SUP] 3 [/SUP], Marianna Papadopoulou[SUP] 1 4 [/SUP], Christos Moschovos[SUP] 1 [/SUP], Ioannis Michopoulos[SUP] 5 [/SUP], Panagiotis Kokotis[SUP] 6 [/SUP], Christos Bakirtzis[SUP] 7 [/SUP], Androniki Naska[SUP] 8 [/SUP], Theodoros I Vassilakopoulos[SUP] 9 [/SUP], Elisabeth Chroni[SUP] 10 [/SUP], Sotirios Tsiodras[SUP] 3 11 [/SUP], Georgios Tsivgoulis[SUP] 1 12 [/SUP]
Affiliations
- PMID: 33837630
- DOI: 10.1111/ene.14860
Abstract
Background: Mounting evidence supports an association between Guillain-Barr? syndrome spectrum (GBSs) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. However, GBSs in the setting of coronavirus disease-2019 (COVID-19) remains poorly characterized, while GBSs prevalence among COVID-19 patients has not been previously systematically evaluated using a meta-analytical approach.
Methods: We performed a systematic review and meta-analysis of observational cohort and case-series studies reporting on the occurrence, clinical characteristics and outcomes of patients with COVID-19-associated GBSs. A random-effects model was used to calculate pooled estimates and odds ratios (ORs) with corresponding 95% confidence intervals (CIs), when comparing to non-COVID-19, contemporary or historical GBSs patients.
Results: We identified 18 eligible studies (11 cohorts, 7 case-series) including a total of 136,746 COVID-19 patients. Among COVID-19 patients, including hospitalized and non-hospitalized cases, the pooled GBSs prevalence was 0.15? (95%CI:0-0.49?; I[SUP]2[/SUP] =96%). Compared to non-infected contemporary or historical controls, patients with SARS-CoV-2 infection had increased odds for demyelinating GBSs subtypes (OR=3.27; 95%CI: 1.32-8.09; I[SUP]2[/SUP] =0%). In SARS-CoV-2 infected patients, olfactory or concomitant cranial nerve involvement was noted in 41.4% (95%CI:3.5-60.4%; I[SUP]2[/SUP] =46%) and 42.8% (95%CI:32.8-53%; I[SUP]2[/SUP] =0%) of the patients, respectively. Clinical outcomes including in-hospital mortality were comparable between COVID-19 GBSs patients and non-infected contemporary or historical GBSs controls.
Conclusions: GBSs prevalence was estimated at 15 cases per 100,000 SARS-CoV-2 infections. COVID-19 appears to be associated with an increased likelihood of GBSs and with demyelinating GBSs variants in particular.
Keywords: COVID-19; Guillain-Barr? syndrome; acute inflammatory demyelinating polyneuropathy; mortality; prevalence.