Meta-analysis Systematic Review (Red)
Mounting evidence supports an association between Guillain‐Barré syndrome spectrum (GBSs) and SARS‐CoV‐2 infection. However, GBSs in the setting of COVID‐19 remains poorly characterized, while GBSs prevalence among COVID‐19 patients has not been previously systematically evaluated using a meta‐analytical approach. The authors of this article performed a systematic review and meta‐analysis of observational cohort and case‐series studies reporting on the occurrence, clinical characteristics and outcomes of patients with COVID‐19‐associated GBSs. A random‐effects model was used to calculate pooled estimates and odds ratios (ORs) with corresponding 95% confidence intervals (CIs), when comparing to non‐COVID‐19, contemporary or historical GBSs patients. 18 eligible studies (11 cohorts, 7 case‐series) were identified including a total of 136,746 COVID‐19 patients. Among COVID‐19 patients, including hospitalized and non‐hospitalized cases, the pooled GBSs prevalence was 0.15‰ (95%CI:0‐0.49‰; I2=96%). Compared to non‐infected contemporary or historical controls, patients with SARS‐CoV‐2 infection had increased odds for demyelinating GBSs subtypes (OR=3.27; 95%CI: 1.32‐8.09; I2=0%). In SARS‐CoV‐2 infected patients, olfactory or concomitant cranial nerve involvement was noted in 41.4% (95%CI:3.5‐60.4%; I2=46%) and 42.8% (95%CI:32.8‐53%; I2=0%) of the patients, respectively. Clinical outcomes including in‐hospital mortality were comparable between COVID‐19 GBSs patients and non‐infected contemporary or historical GBSs controls. The author concluded that GBSs prevalence was estimated at 15 cases per 100,000 SARS‐CoV‐2 infections. COVID‐19 appears to be associated with an increased likelihood of GBSs and with demyelinating GBSs variants in particular.
Lina Palaiodimou et al. Prevalence, clinical characteristics and outcomes of Guillain‐Barré syndrome spectrum associated with COVID‐19: a systematic review and meta‐analysis. European Journal of Neurology. https://doi.org/10.1111/ene.14860