Annals of Indian Academy of Neurology (Jan 2022)

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,
  • Rajinder K Dhamija,
  • Aditya Choudhary,
  • Ritu Shree,
  • Sujit Kumar,
  • Priyanka Samal,
  • Abhishek Pathak,
  • Pamidimukkala Vijaya,
  • Yareeda Sireesha,
  • Sruthi S Nair,
  • Sanjay Sharma,
  • Soaham Desai,
  • Human P Sinha,
  • Ayush Agarwal,
  • Ashish Upadhyay,
  • M V Padma Srivastava,
  • Rohit Bhatia,
  • Awadh K Pandit,
  • Rajesh K Singh,
  • Alisha Reyaz,
  • P M Yogeesh,
  • Manish Salunkhe,
  • Vivek Lal,
  • Manish Modi,
  • Gagandeep Singh,
  • Monika Singla,
  • Samhita Panda,
  • Maya Gopalakrishnan,
  • Inder Puri,
  • Sudhir Sharma,
  • Bismay Kumar,
  • Prashant K Kushwaha,
  • Harshadkumar Chovatiya,
  • Teresa Ferreira,
  • Sanjeev K Bhoi,
  • Manish Bhartiya,
  • Subhash Kaul,
  • Anuja Patil,
  • Neeharika L Mathukumalli,
  • Madhu Nagappa,
  • P Praveen Sharma,
  • Aneesh Basheer,
  • Dileep Ramachandran,
  • Neetha Balaram,
  • Jospeh Sebastian,
  • Venugopalan Y Vishnu,
  • on behalf of the GBS consortium

DOI
https://doi.org/10.4103/aian.aian_392_21
Journal volume & issue
Vol. 25, no. 1
pp. 60 – 67

Abstract

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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.

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