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Guillain‐Barré syndrome associated with SARS‐CoV ‐2 infection: A systematic review and individual participant data meta‐analysis
Author(s) -
Hasan Imran,
SaifUrRahman KM,
Hayat Shoma,
Papri Nowshin,
Jahan Israt,
Azam Rufydha,
Ara Gulshan,
Islam Zhahirul
Publication year - 2020
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1111/jns.12419
Subject(s) - medicine , guillain barre syndrome , interquartile range , meta analysis , cochrane library , plasmapheresis , medline , pediatrics , antibody , immunology , political science , law
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.