@article{2997032,
    title = "Prevalence, clinical characteristics and outcomes of Guillain−Barré syndrome spectrum associated with COVID-19: A systematic review and meta-analysis",
    author = "Palaiodimou, L. and Stefanou, M.-I. and Katsanos, A.H. and Fragkou, P.C. and Papadopoulou, M. and Moschovos, C. and Michopoulos, I. and Kokotis, P. and Bakirtzis, C. and Naska, A. and Vassilakopoulos, T.I. and Chroni, E. and Tsiodras, S. and Tsivgoulis, G.",
    journal = "European Journal of Paediatric Neurology",
    year = "2021",
    volume = "28",
    number = "10",
    pages = "3517-3529",
    publisher = "John Wiley and Sons Inc",
    issn = "1090-3798",
    doi = "10.1111/ene.14860",
    keywords = "immunoglobulin, adult;  clinical feature;  clinical outcome;  controlled study;  coronavirus disease 2019;  cranial neuropathy;  disease association;  Guillain Barre syndrome;  hospital patient;  human;  in-hospital mortality;  middle aged;  olfactory nerve disease;  plasmapheresis;  prevalence;  Review;  systematic review;  Guillain Barre syndrome;  hospital mortality;  meta analysis;  prevalence, COVID-19;  Guillain-Barre Syndrome;  Hospital Mortality;  Humans;  Prevalence;  SARS-CoV-2",
    abstract = "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‰; I2 = 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%; I2 = 0%). In SARS-CoV-2-infected patients, olfactory or concomitant cranial nerve involvement was noted in 41.4% (95% CI 3.5%–60.4%; I2 = 46%) and 42.8% (95% CI 32.8%–53%; I2 = 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. © 2021 European Academy of Neurology"
}