Guillain-Barré syndrome in SARS-CoV-2 infection: an instant systematic review of the first six months of pandemic

A systematic review from 1 January to 30 June 2020 revealed 42 patients with Guillain-Barré syndrome (GBS) associated with SARS-CoV-2 infection. Single cases and small series were reported from 13 countries, the majority from Europe (79.4%) and especially from Italy (30.9%). SARS-CoV-2 infection was...

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Veröffentlicht in:Journal of neurology, neurosurgery and psychiatry Jg. 91; H. 10; S. 1105 - 1110
Hauptverfasser: Uncini, Antonino, Vallat, Jean-Michel, Jacobs, Bart C
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England BMJ Publishing Group Ltd 01.10.2020
BMJ Publishing Group LTD
Schlagworte:
Adult
Aged
Ataxia
Betacoronavirus
Coronavirus Infections - complications
Coronavirus Infections - diagnosis
Coronavirus Infections - therapy
Coronaviruses
COVID-19
Cytomegalovirus
Disease transmission
Encephalitis
Female
Fever
Guillain-Barre syndrome
Guillain-Barre Syndrome - diagnosis
Guillain-Barre Syndrome - therapy
Guillain-Barre Syndrome - virology
Humans
Infections
Laboratories
Male
Middle Aged
Neuromuscular
neurovirology
Pandemics
Patients
Pneumonia
Pneumonia, Viral - complications
Pneumonia, Viral - diagnosis
Pneumonia, Viral - therapy
SARS-CoV-2
Serology
Severe acute respiratory syndrome coronavirus 2
Systematic review
systematic reviews
Ventilators
Young Adult
Italy
China
Guillain-Barre syndrome
neurovirology
systematic reviews
ISSN:0022-3050, 1468-330X, 1468-330X
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Zusammenfassung:A systematic review from 1 January to 30 June 2020 revealed 42 patients with Guillain-Barré syndrome (GBS) associated with SARS-CoV-2 infection. Single cases and small series were reported from 13 countries, the majority from Europe (79.4%) and especially from Italy (30.9%). SARS-CoV-2 infection was demonstrated by nasopharyngeal swab (85.7%) and serology (14.3%). Median time between COVID-19 and GBS onset in 36 patients was 11.5 days (IQR: 7.7–16). The most common clinical features were: limb weakness (76.2%), hypoareflexia (80.9 %), sensory disturbances (66.7 %) and facial palsy (38.1%). Dysautonomia occurred in 19%, respiratory failure in 33.3% and 40.5% of patients were admitted in intensive care unit. Most patients (71.4%) had the classical clinical presentation but virtually all GBS variants and subtypes were reported. Cerebrospinal fluid (CSF) albumin-cytological dissociation was found in 28/36 (77.8%) and PCR for SARS-CoV-2 was negative in 25/25 patients. Electrodiagnosis was demyelinating in 80.5% and levels 1 and 2 of Brighton criteria of diagnostic certainty, when applicable, were fulfilled in 94.5% patients. Antiganglioside antibodies were positive in only 1/22 patients. Treatments were intravenous immunoglobulin and/or plasma exchange (92.8%) with, at short-time follow-up, definite improvement or recovery in 62.1% of patients. One patient died. In conclusion, the most frequent phenotype of GBS in SARS-CoV-2 infection is the classical sensorimotor demyelinating GBS responding to the usual treatments. The time interval between infectious and neuropathic symptoms, absence of CSF pleocytosis and negative PCR support a postinfectious mechanism. The abundance of reports suggests a pathogenic link between SARS-CoV-2 infection and GBS but a case-control study is greatly needed.
Bibliographie:Review
ObjectType-Article-1
ObjectType-Evidence Based Healthcare-3
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ObjectType-Undefined-3
ISSN:0022-3050
1468-330X
1468-330X
DOI:10.1136/jnnp-2020-324491