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. 2021 Sep 7;26(5):196-224.
doi: 10.1097/NRL.0000000000000342.

Treatment Options for COVID-19-Related Guillain-Barré Syndrome: A Systematic Review of Literature

Sogand Goudarzi  1 , Shooka Esmaeeli  2   3 , Juan D Valencia  2 , Maegan E Lu  3 , Riley R Hales  3 , Corey R Fehnel  4 , Christopher M Conley  3 , Sadeq A Quraishi  5 , Ala Nozari  3
Affiliations

Treatment Options for COVID-19-Related Guillain-Barré Syndrome: A Systematic Review of Literature

Sogand Goudarzi et al. Neurologist. .

Abstract

Background: Central nervous system complications are reported in an increasing number of patients with Coronavirus Disease 2019 (COVID-19). COVID-19-related Guillain-Barré syndrome (GBS) is of particular importance given its association with higher mortality rates and prolonged respiratory failure.

Review summary: We conducted a systematic review of published cases for COVID-19-related GBS, and provide a summary of clinical management strategies for these cases. Sixty-three studies, including 86 patients, were included. Seventy-six cases with reported outcome data were eligible for the outcome analysis. Ninety-nine percent of patients were diagnosed with COVID-19 before diagnosis of GBS (median: 14 d prior, interquartile range: 7 to 20). Intravenous immunotherapy (intravenous immunoglobulin: 0.4 g/kg/d for 5 d) was the most frequently used treatment approach. The review indicated that the outcome was not favorable in 26% of cases (persistent neurological deficits). A mortality rate of 3.5% was observed in patients with COVID-19-related GBS.

Conclusions: Although evidence to support specific treatments is lacking, clinicians should consider the benefits of immunotherapy and plasma exchange in addition to the standard antimicrobial and supportive therapies for patients who meet the diagnostic criteria for acute sensory and motor polyradiculoneuritis. Intravenous immunoglobulin treatment alone is not shown to result in improved outcomes or mortality. More extensive studies aimed at exploring the neurological manifestations and complications of COVID-19 and distinctive treatment options for COVID-19-related GBS are warranted.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
ACE2-binding SARS-CoV-2 causes various complications in different organs that can lead to neurological complications. ACE2 indicates angiotensin-converting enzyme 2; BBB, blood-brain barrier; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
FIGURE 2
FIGURE 2
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.
FIGURE 3
FIGURE 3
Geographical distribution of the Coronavirus Disease 2019 (COVID-19)-related Guillain-Barré syndrome cases.
See this image and copyright information in PMC

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References

    1. Verdecchia P, Cavallini C, Spanevello A, et al. . The pivotal link between ACE2 deficiency and SARS-CoV-2 infection. Eur J Intern Med. 2020;76:14–20. - PMC - PubMed
    1. Whittaker A, Anson M, Harky A. Neurological manifestations of COVID-19: a review. Acta Neurol Scand. 2020;142:14–22. - PMC - PubMed
    1. Vonck K, Garrez I, De Herdt V, et al. . Neurological manifestations and neuro-invasive mechanisms of the severe acute respiratory syndrome coronavirus type 2. Eur J Neurol. 2020;27:1578–1587. - PMC - PubMed
    1. Scheidl E, Canseco DD, Hadji-Naumov A, et al. . Guillain-Barre syndrome during SARS-CoV-2 pandemic: a case report and review of recent literature. J Peripher Nerv Syst. 2020;25:204–207. - PMC - PubMed
    1. Montalvan V, Lee J, Bueso T, et al. . Neurological manifestations of COVID-19 and other coronavirus infections: a systematic review. Clin Neurol Neurosurg. 2020;194:105921. - PMC - PubMed

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