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Prevalence, clinical characteristics and outcomes of Guillain−Barré syndrome spectrum associated with COVID‐19: A systematic review and meta‐analysis
Author(s) -
Palaiodimou Lina,
Stefanou MariaIoanna,
Katsanos Aristeidis H.,
Fragkou Paraskevi C.,
Papadopoulou Marianna,
Moschovos Christos,
Michopoulos Ioannis,
Kokotis Panagiotis,
Bakirtzis Christos,
Naska Androniki,
Vassilakopoulos Theodoros I.,
Chroni Elisabeth,
Tsiodras Sotirios,
Tsivgoulis Georgios
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14860
Subject(s) - medicine , odds ratio , guillain barre syndrome , confidence interval , meta analysis , covid-19 , pediatrics , disease , infectious disease (medical specialty)
Background and purpose Mounting evidence supports an association between Guillain−Barré 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, whilst GBSs prevalence amongst COVID‐19 patients has not been previously systematically evaluated using a meta‐analytical approach. Methods 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 was performed. A random‐effects model was used to calculate pooled estimates and odds ratios (ORs) with corresponding 95% confidence intervals (CIs), compared to non‐COVID‐19, contemporary or historical GBSs patients. Results Eighteen eligible studies (11 cohorts, seven case series) were identified including a total of 136,746 COVID‐19 patients. Amongst COVID‐19 patients, including hospitalized and non‐hospitalized cases, the pooled GBSs prevalence was 0.15‰ (95% CI 0%–0.49‰; I 2 = 96%). Compared with 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 2 = 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 2 = 46%) and 42.8% (95% CI 32.8%–53%; I 2 = 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. Conclusion 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.