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. 2022 Jan-Feb;25(1):60-67.
doi: 10.4103/aian.aian_392_21. Epub 2021 Nov 17.

Impact of the COVID-19 Pandemic on the Frequency, Clinical Spectrum and Outcomes of Pediatric Guillain-Barré Syndrome in India: A Multicentric Ambispective Cohort Study

Divyani Garg  1 , Rajinder K Dhamija  1 , Aditya Choudhary  2 , Ritu Shree  3 , Sujit Kumar  4 , Priyanka Samal  5 , Abhishek Pathak  6 , Pamidimukkala Vijaya  7 , Yareeda Sireesha  8 , Sruthi S Nair  9 , Sanjay Sharma  10 , Soaham Desai  11 , Human P Sinha  12 , Ayush Agarwal  13 , Ashish Upadhyay  13 , M V Padma Srivastava  13 , Rohit Bhatia  13 , Awadh K Pandit  13 , Rajesh K Singh  13 , Alisha Reyaz  13 , P M Yogeesh  13 , Manish Salunkhe  13 , Vivek Lal  3 , Manish Modi  3 , Gagandeep Singh  14 , Monika Singla  14 , Samhita Panda  15 , Maya Gopalakrishnan  15 , Inder Puri  16 , Sudhir Sharma  17 , Bismay Kumar  6 , Prashant K Kushwaha  12 , Harshadkumar Chovatiya  11 , Teresa Ferreira  18 , Sanjeev K Bhoi  19 , Manish Bhartiya  20 , Subhash Kaul  21 , Anuja Patil  21 , Neeharika L Mathukumalli  8 , Madhu Nagappa  22 , P Praveen Sharma  22 , Aneesh Basheer  23 , Dileep Ramachandran  24 , Neetha Balaram  24 , Jospeh Sebastian  25 , Venugopalan Y Vishnu  13 ; GBS consortium
Affiliations

Impact of the COVID-19 Pandemic on the Frequency, Clinical Spectrum and Outcomes of Pediatric Guillain-Barré Syndrome in India: A Multicentric Ambispective Cohort Study

Divyani Garg et al. Ann Indian Acad Neurol. 2022 Jan-Feb.

Abstract

Objective: To study impact of COVID-19 pandemic on frequency, clinical/electrophysiological profile and treatment outcomes in pediatric Guillain-Barré syndrome (GBS).

Background: GBS is the most frequent cause of pediatric acute flaccid paralysis. The effect of the COVID-19 pandemic on pediatric GBS is unclear in the literature.

Methods: We conducted an ambispective, multicentric, cohort study involving 12 of 27 centres in GBS Consortium, during two periods: pre-COVID-19 (March-August 2019) and during COVID-19 (March-August 2020). Children ≤12 years who satisfied National Institute of Neurological Diseases and Stroke criteria for GBS/variants were enrolled. Details pertaining to clinical/laboratory parameters, treatment and outcomes (modified Rankin Scale (mRS) at discharge, GBS Disability score at discharge and 3 months) were analysed.

Results: We enrolled 33 children in 2019 and 10 in 2020. Children in 2020 were older (median 10.4 [interquartile range 6.75-11.25] years versus 5 (2.5-8.4) years; P = 0.022) and had more sensory symptoms (50% versus 18.2%; P = 0.043). The 2020 group had relatively favourable mRS at discharge (median 1 (1-3.5) versus 3 (2-4); P = 0.042) and GBS disability score at 3 months (median 0 (0-0.75) versus 2 (0-3); P = 0.009) compared to 2019. Multivariate analysis revealed bowel involvement (P = 0.000) and ventilatory support (P = 0.001) as independent predictors of disability. No child in 2020 had preceding/concurrent SARS-CoV2 infection.

Conclusions: The COVID-19 pandemic led to a marked decline in pediatric GBS presenting to hospitals. Antecedent illnesses, clinical and electrophysiological profile of GBS remained largely unchanged from the pre-pandemic era.

Keywords: AIDP; AMAN; COVID-19; Guillain–Barre syndrome; IVIg; SARS-CoV2.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of centers participating in this study across India
See this image and copyright information in PMC

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