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Open Access 01-04-2021 | Coronavirus | Review

Guillain–Barré syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases

Authors: Samir Abu-Rumeileh, Ahmed Abdelhak, Matteo Foschi, Hayrettin Tumani, Markus Otto

Published in: Journal of Neurology | Issue 4/2021

Abstract

Since coronavirus disease-2019 (COVID-19) outbreak in January 2020, several pieces of evidence suggested an association between the spectrum of Guillain–Barré syndrome (GBS) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Most findings were reported in the form of case reports or case series, whereas a comprehensive overview is still lacking. We conducted a systematic review and searched for all published cases until July 20th 2020. We included 73 patients reported in 52 publications. A broad age range was affected (mean 55, min 11–max 94 years) with male predominance (68.5%). Most patients showed respiratory and/or systemic symptoms, and developed GBS manifestations after COVID-19. However, asymptomatic cases for COVID-19 were also described. The distributions of clinical variants and electrophysiological subtypes resemble those of classic GBS, with a higher prevalence of the classic sensorimotor form and the acute inflammatory demyelinating polyneuropathy, although rare variants like Miller Fisher syndrome were also reported. Cerebrospinal fluid (CSF) albuminocytological dissociation was present in around 71% cases, and CSF SARS-CoV-2 RNA was absent in all tested cases. More than 70% of patients showed a good prognosis, mostly after treatment with intravenous immunoglobulin. Patients with less favorable outcome were associated with a significantly older age in accordance with previous findings regarding both classic GBS and COVID-19. COVID-19-associated GBS seems to share most features of classic post-infectious GBS and possibly the same immune-mediated pathogenetic mechanisms. Nevertheless, more extensive epidemiological studies are needed to clarify these issues.

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Title: Guillain–Barré syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases
Authors: Samir Abu-Rumeileh
Ahmed Abdelhak
Matteo Foschi
Hayrettin Tumani
Markus Otto
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Keywords: Coronavirus
Guillain-Barré Syndrome
Cough
Tetraparesis
SARS-CoV-2
Cough
Cough
COVID-19
Published in: Journal of Neurology / Issue 4/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10124-x

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Guillain–Barré syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases

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