Guillain-Barré syndrome associated with SARS-CoV-2 infection: A systematic review and individual participant data meta-analysis

Publikation: Bidrag til tidsskriftReviewForskningfagfællebedømt

  • Imran Hasan
  • K M Saif-Ur-Rahman
  • Shoma Hayat
  • Nowshin Papri
  • Israt Jahan
  • Rufydha Azam
  • Ara, Gulshan
  • Zhahirul Islam

Several published reports have described a possible association between Guillain-Barré 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. We searched the PubMed (Medline), Web of Science and Cochrane databases for articles published between 01 January 2020 and 05 August 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. 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 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 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. 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. PROSPERO Registration Number CRD42020201673.

OriginalsprogEngelsk
TidsskriftJournal of the Peripheral Nervous System
Vol/bind25
Udgave nummer4
Sider (fra-til)335-343
Antal sider9
ISSN1085-9489
DOI
StatusUdgivet - 2020
Eksternt udgivetJa

Bibliografisk note

(Ekstern)

Funding Information:
icddr,b is grateful to the Governments of Bangladesh, Canada, Sweden and the United Kingdom for providing core/unrestricted support. We would like to thank Dr García-Manzanedo and colleagues for providing the English translation of their case report.

Funding Information:
Zhahirul Islam received grants from the Fogarty International Center, National Institute of Neurological Disorders and Stroke of the National Institutes of Health, USA under Award Number K43 TW011447 and Annexon Biosciences (South San Francisco, CA 94080, USA). The other authors do not have any conflict of interests.

Publisher Copyright:
© 2020 Peripheral Nerve Society.

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