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Meta-Analysis
. 2022 Dec 13;58(12):1835.
doi: 10.3390/medicina58121835.

Concomitant Guillain-Barré Syndrome and COVID-19: A Meta-Analysis of Cases

Skylar A Bentley  1   2 , Sarfraz Ahmad  3   4 , Firas H Kobeissy  5 , Hale Z Toklu  3
Affiliations
Meta-Analysis

Concomitant Guillain-Barré Syndrome and COVID-19: A Meta-Analysis of Cases

Skylar A Bentley et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Recent findings demonstrate that the transmigration of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) to the nervous system implicates severe neurotropic pathologies, including the onset of the rare disease called Guillain-Barré syndrome (GBS) which is characterized by immune-mediated polyneuropathy. This study aimed to identify the predisposing factors and the clinical features of coronavirus disease 2019 (COVID-19)-induced GBS. Materials and Methods: We have performed an analysis of 147 cases. A systematic review of the published research work was performed per the PRISMA statement to obtain individual participant data (IPD) for the meta-analysis. The search was conducted through PubMed, using the combined search terms "Guillain-Barré syndrome" and "COVID-19". All case reports and series in the English language with accessed full text were included in the search. Results: A systematic database search led to the retrieval of 112 peer-reviewed articles published between 1 April 2020, and 8 February 2022. The articles comprised 16 case series and 96 case reports containing IPD for 147 patients. Our findings showed that 77.6% of all cases were 40 years or older. Males comprised most of the cases (65.3%; n = 96). The intensive care unit (ICU) admission was 44.9%, and the need for mechanical ventilation (MV) was 38.1%. The patients presented with hyporeflexia or areflexia (84.4%; n = 124), lower limb strength and sensation impairment (93.2%; n = 138), upper limb strength and sensation impairment (85.7; n = 126), and somatic sensation impairment (72.8%; n = 107). The patients presented with increased cerebral spinal fluid (CSF) protein levels (92%; n = 92) and the presence of CSF albuminocytological dissociation (83.5%; n = 71). The most common variant of GBS observed was acute inflammatory demyelinating polyneuropathy (AIDP). We found that predisposing factors concomitant with COVID-19 and GBS were male gender and older age. Among the cases, patient mortality was 10.9%. Conclusions: A gap of knowledge exists regarding the complete spectrum of clinical characteristics of COVID-19-related GBS. Recent findings suggest that SARS-CoV-2 triggers GBS, as it follows a similar para-infectious pattern as the other viral agents contributing to the onset of GBS.

Keywords: COVID-19; GBS; Guillain–Barré syndrome; SARS-CoV-2; meta-analysis; neurological complications.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Article exclusion flow chart (PRISMA).
Figure 1
Figure 1
Serum anti-ganglioside antibodies test result.
Figure 2
Figure 2
Cerebrospinal fluid protein values.
Figure 3
Figure 3
Percentage of cases with limb function abnormalities.
Figure 4
Figure 4
Sensory nerve and compound muscle action potential.
See this image and copyright information in PMC

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