TY - JOUR
TI - Prevalence, clinical characteristics and outcomes of Guillain−Barré syndrome spectrum associated with COVID-19: A systematic review and meta-analysis
AU - Palaiodimou, L.
AU - Stefanou, M.-I.
AU - Katsanos, A.H.
AU - Fragkou, P.C.
AU - Papadopoulou, M.
AU - Moschovos, C.
AU - Michopoulos, I.
AU - Kokotis, P.
AU - Bakirtzis, C.
AU - Naska, A.
AU - Vassilakopoulos, T.I.
AU - Chroni, E.
AU - Tsiodras, S.
AU - Tsivgoulis, G.
JO - European Journal of Paediatric Neurology
PY - 2021
VL - 28
TODO - 10
SP - 3517-3529
PB - John Wiley and Sons Inc
SN - 1090-3798
TODO - 10.1111/ene.14860
TODO - 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
TODO - 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
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