COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports [version 2; peer review: 2 approved]
Background: Guillain-Barre Syndrome (GBS) is a neurological autoimmune disease that can lead to respiratory failure and death. Whether COVID-19 patients are at high risk of GBS is unknown. Through a systematic review of case reports, we aimed to summarize the main features of patients with GBS and C...
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doaj-f1a57f544ba545a895498b9e39abc70d2020-11-25T03:18:54ZengWellcomeWellcome Open Research2398-502X2020-09-01510.12688/wellcomeopenres.15987.217955COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports [version 2; peer review: 2 approved]Rodrigo M. Carrillo-Larco0Carlos Altez-Fernandez1Sabrina Ravaglia2Joaquín A. Vizcarra3CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, PeruFacultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, PeruIRCCS C., Mondino Foundation, Pavia, ItalyDepartment of Neurology, Emory University, Atlanta, USABackground: Guillain-Barre Syndrome (GBS) is a neurological autoimmune disease that can lead to respiratory failure and death. Whether COVID-19 patients are at high risk of GBS is unknown. Through a systematic review of case reports, we aimed to summarize the main features of patients with GBS and COVID-19. Methods: Without any restrictions, we searched MEDLINE, Embase, Global Health, Scopus, Web of Science and MedXriv (April 23 rd, 2020). Two reviewers screened and studied titles, abstracts and reports. We extracted information to characterize sociodemographic variables, clinical presentation, laboratory results, treatments and outcomes. Results: Eight reports (n=12 patients) of GBS and COVID-19 were identified; one was a Miller Fisher case. The age ranged between 23 and 77 years, and there were more men (9/102). GBS symptoms started between 5 and 24 days after those of COVID-19. The protein levels in cerebrospinal fluid samples ranged between 40 and 193 mg/dl. None of the cerebrospinal fluid samples tested positive for COVID-19. Six patients debuted with ascendant weakness and three with facial weakness. Five patients had favourable evolution, four remained with relevant symptoms or required critical care and one died; the Miller Fisher case had successful resolution. Conclusions: GBS is emerging as a disease that may appear in COVID-19 patients. Although limited, preliminary evidence appears to suggest that GBS occurs after COVID-19 onset. Practitioners and investigators should have GBS in mind as they look after COVID-19 patients and conduct research on novel aspects of COVID-19. Comparison with GBS patients in the context of another viral outbreak (Zika), revealed similarities and differences that deserves further scrutiny and epidemiological studies.https://wellcomeopenresearch.org/articles/5-107/v2 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rodrigo M. Carrillo-Larco Carlos Altez-Fernandez Sabrina Ravaglia Joaquín A. Vizcarra |
spellingShingle |
Rodrigo M. Carrillo-Larco Carlos Altez-Fernandez Sabrina Ravaglia Joaquín A. Vizcarra COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports [version 2; peer review: 2 approved] Wellcome Open Research |
author_facet |
Rodrigo M. Carrillo-Larco Carlos Altez-Fernandez Sabrina Ravaglia Joaquín A. Vizcarra |
author_sort |
Rodrigo M. Carrillo-Larco |
title |
COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports [version 2; peer review: 2 approved] |
title_short |
COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports [version 2; peer review: 2 approved] |
title_full |
COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports [version 2; peer review: 2 approved] |
title_fullStr |
COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports [version 2; peer review: 2 approved] |
title_full_unstemmed |
COVID-19 and Guillain-Barre Syndrome: a systematic review of case reports [version 2; peer review: 2 approved] |
title_sort |
covid-19 and guillain-barre syndrome: a systematic review of case reports [version 2; peer review: 2 approved] |
publisher |
Wellcome |
series |
Wellcome Open Research |
issn |
2398-502X |
publishDate |
2020-09-01 |
description |
Background: Guillain-Barre Syndrome (GBS) is a neurological autoimmune disease that can lead to respiratory failure and death. Whether COVID-19 patients are at high risk of GBS is unknown. Through a systematic review of case reports, we aimed to summarize the main features of patients with GBS and COVID-19. Methods: Without any restrictions, we searched MEDLINE, Embase, Global Health, Scopus, Web of Science and MedXriv (April 23 rd, 2020). Two reviewers screened and studied titles, abstracts and reports. We extracted information to characterize sociodemographic variables, clinical presentation, laboratory results, treatments and outcomes. Results: Eight reports (n=12 patients) of GBS and COVID-19 were identified; one was a Miller Fisher case. The age ranged between 23 and 77 years, and there were more men (9/102). GBS symptoms started between 5 and 24 days after those of COVID-19. The protein levels in cerebrospinal fluid samples ranged between 40 and 193 mg/dl. None of the cerebrospinal fluid samples tested positive for COVID-19. Six patients debuted with ascendant weakness and three with facial weakness. Five patients had favourable evolution, four remained with relevant symptoms or required critical care and one died; the Miller Fisher case had successful resolution. Conclusions: GBS is emerging as a disease that may appear in COVID-19 patients. Although limited, preliminary evidence appears to suggest that GBS occurs after COVID-19 onset. Practitioners and investigators should have GBS in mind as they look after COVID-19 patients and conduct research on novel aspects of COVID-19. Comparison with GBS patients in the context of another viral outbreak (Zika), revealed similarities and differences that deserves further scrutiny and epidemiological studies. |
url |
https://wellcomeopenresearch.org/articles/5-107/v2 |
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