COVID-19-associated Guillain-Barré syndrome in the early pandemic experience in Lombardia (Italy)

Neurol Sci. 2023 Feb;44(2):437-446. doi: 10.1007/s10072-022-06429-6. Epub 2022 Oct 26.

Abstract

Objective: To estimate the incidence and describe clinical characteristics and outcome of GBS in COVID-19 patients (COVID19-GBS) in one of the most hit regions during the first pandemic wave, Lombardia.

Methods: Adult patients admitted to 20 Neurological Units between 1/3-30/4/2020 with COVID19-GBS were included as part of a multi-center study organized by the Italian society of Hospital Neuroscience (SNO).

Results: Thirty-eight COVID19-GBS patients had a mean age of 60.7 years and male frequency of 86.8%. CSF albuminocytological dissociation was detected in 71.4%, and PCR for SARS-CoV-2 was negative in 19 tested patients. Based on neurophysiology, 81.8% of patients had a diagnosis of AIDP, 12.1% of AMSAN, and 6.1% of AMAN. The course was favorable in 76.3% of patients, stable in 10.5%, while 13.2% worsened, of which 3 died. The estimated occurrence rate in Lombardia ranges from 0.5 to 0.05 GBS cases per 1000 COVID-19 infections depending on whether you consider positive cases or estimated seropositive cases. When we compared GBS cases with the pre-pandemic period, we found a reduction of cases from 165 to 135 cases in the 2-month study period in Lombardia.

Conclusions: We detected an increased incidence of GBS in COVID-19 patients which can reflect a higher risk of GBS in COVID-19 patients and a reduction of GBS events during the pandemic period possibly due to a lower spread of more common respiratory infectious diseases determined by an increased use of preventive measures.

Keywords: COVID-19; Coronavirus infections; Guillain-Barré syndrome; SARS-CoV-2 infection.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • Guillain-Barre Syndrome* / diagnosis
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Pandemics
  • SARS-CoV-2