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. 2021 Jan 15:420:117263.
doi: 10.1016/j.jns.2020.117263. Epub 2020 Dec 9.

Guillain Barré Syndrome and its variants as a manifestation of COVID-19: A systematic review of case reports and case series

Shitiz Sriwastava  1 , Saurabh Kataria  2 , Medha Tandon  3 , Jenil Patel  4 , Riddhi Patel  5 , Abbas Jowkar  6 , Maha Daimee  7 , Evanthia Bernitsas  8 , Preeti Jaiswal  9 , Robert P Lisak  10
Affiliations

Guillain Barré Syndrome and its variants as a manifestation of COVID-19: A systematic review of case reports and case series

Shitiz Sriwastava et al. J Neurol Sci. .

Abstract

Background: The COVID-19 pandemic caused by SARS-COV-2 began in Wuhan, China in December 2019. Reports of COVID-19 with central (CNS) and peripheral nervous (PNS) system manifestations are emerging. In this systematic review, we compared and summarized the demographics, clinical features, Brighton criteria, immunological and laboratory findings with a focus on modified Erasmus GBS Outcome Score (mEGOS) in SARS-CoV-2 patients with GBS and its variants.

Methods: Based on PRISMA guidelines, we searched three databases (PubMed, Scopus, and Google Scholar) for studies on COVID-19 and GBS between December 1, 2019 to July 15, 2020. For descriptive analysis, we studied two groups with: 1) acute inflammatory demyelinating polyradiculoneuropathy (AIDP) variant, and 2) Non-AIDP/Other variants. We compared mEGOS scores for patients in both groups along with other key clinical features.

Results: Of the 50 GBS cases identified from 37 studies, 33 (66%) had acute inflammatory demyelinating polyradiculopolyneuropathy (AIDP) while 17 (34%) were of other (non-AIDP) variants. There mEGOS scores did not differ between AIDP patients and AMAN/AMSAN patients. Majority of the AIDP (66.7%) and AMAN/AMSAN (57.2%) patients belonged to Brighton level 1 indicating maximum diagnostic certainty.

Conclusion: To our knowledge, this is among the first reviews that includes GBS variants and the clinical prediction tool mEGOS for prognostication in COVID-19 patients. Further research is needed to assess whether IVIG is preferable over plasmapheresis in this population of GBS patients. It would also be crucial to follow these patients over time to identify the long-term disability as well as treatment outcomes.

Keywords: AIDP; AMSAN; Bickerstaff encephalitis; COVID-19; GBS; MFS; SARS-CoV-2.

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Figures

Fig. 1
Fig. 1
PRISMA flow diagram of systemic review. The flow diagram depicts the flow of information through the different phases of the systematic review. It maps out the number of records identified, included and excluded, and the reasons for exclusions.
See this image and copyright information in PMC

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