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. 2022 Nov-Dec;25(6):1116-1121.
doi: 10.4103/aian.aian_523_22. Epub 2022 Dec 3.

Impact of COVID-19 on Guillain-Barre Syndrome in India: A Multicenter Ambispective Cohort Study

Yareeda Sireesha  1 , Ritu Shree  2 , Madhu Nagappa  3 , Anuja Patil  4 , Monika Singla  5 , M V Padma Srivastava  6 , R K Dhamija  7 , Neetha Balaram  8 , Abhishek Pathak  9 , Dileep Ramachandran  10 , Sujit Kumar  11 , Inder Puri  12 , Sudhir Sharma  13 , Samhita Panda  14 , Soaham Desai  15 , Priyanka Samal  16 , Aditya Choudhary  17 , Pamidimukkala Vijaya  18 , Teresa Ferreira  19 , S S Nair  20 , H P Sinha  21 , S K Bhoi  22 , Joseph Sebastian  23 , Sanjay Sharma  24 , Aneesh Basheer  25 , Manish Bhartiya  26 , N L Mathukumalli  1 , Shaikh Afshan Jabeen  1 , Vivek Lal  2 , Manish Modi  2 , P Praveen Sharma  3 , Subash Kaul  4 , Gagandeep Singh  5 , Ayush Agarwal  6 , Divyani Garg  7 , James Jose  8 , Priya Dev  9 , Thomas Iype  10 , Maya Gopalakrishnan  14 , Ashish Upadhyay  6 , Rohit Bhatia  6 , Awadh K Pandit  6 , Rajesh K Singh  6 , Manish Salunkhe  6 , P M Yogeesh  6 , Alisha Reyaz  6 , Nishant Nadda  13 , Menkha Jha  22 , Bismay Kumar  9 , P K Kushwaha  21 , Harshadkumar Chovatiya  15 , Bhavani Madduluri  1 , P Ramesh  1 , Abeer Goel  2 , Rahul Yadav  15 , Venugopalan Y Vishnu  6 ; GBS consortium
Affiliations

Impact of COVID-19 on Guillain-Barre Syndrome in India: A Multicenter Ambispective Cohort Study

Yareeda Sireesha et al. Ann Indian Acad Neurol. 2022 Nov-Dec.

Abstract

Introduction/aims: Studies conducted during the coronavirus disease 2019 (COVID-19) pandemic have reported varied data regarding the incidence of Guillain-Barre syndrome (GBS). The present study investigated demographic and clinical features, management, and outcomes of patients with GBS during a specified period of the COVID-19 pandemic, and compared these features to those of GBS in the previous year.

Methods: A multicenter, ambispective cohort study including 26 centers across India was conducted. Data from a pre-COVID-19 period (March 1 to August 31, 2019) were collected retrospectively and collected ambispectively for a specified COVID-19 period (March 1 to August 31, 2020). The study was registered with the Clinical Trial Registry India (CTRI/2020/11/029143).

Results: Data from 555 patients were included for analysis: pre-COVID-19 (n = 334) and COVID-19 (n = 221). Males were more commonly affected during both periods (male:female, 2:1). Gastroenteritis was the most frequent antecedent event in 2019 (17.4%), whereas fever was the most common event in 2020 (10.7%). Paraparesis (21.3% versus [vs.] 9.3%, P = 0.001) and sensory involvement (51.1% vs. 41.3%; P = 0.023) were more common during COVID-19 in 2020, whereas back pain (26.3% vs. 18.4%; P = 0.032) and bowel symptoms (20.7% vs. 13.7%; P = 0.024) were more frequent in the pre-COVID period. There was no difference in clinical outcomes between the two groups in terms of GBS disability score at discharge and 3 months after discharge. Independent predictors of disability in the pre-COVID period included areflexia/hyporeflexia, the requirementfor intubation, and time to bulbar weakness; in the COVID-19 period, independent predictors included time from onset to admission, intubation, and intubation requirement. The mortality rate was 2.3% during the entire study period (13/555 cases).

Discussion: Results of this study revealed an overall reduction in the frequency of GBS during the pandemic. The lockdown likely reduced the risk for antecedent infections due to social distancing and improved hygiene, which may have resulted in the reduction of the frequency of GBS.

Keywords: Areflexia; COVID-19; GBS; Guillain–Barré.

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Conflict of interest statement

There are no conflicts of interest.

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