Annals of Indian Academy of Neurology (Jan 2021)

Guillian--Barre' syndrome in patients with SARS-CoV-2: A multicentric study from Maharashtra, India

  • Megha C Dhamne,
  • Rajesh Benny,
  • Rakesh Singh,
  • Amitkumar Pande,
  • Pankaj Agarwal,
  • Satish Wagh,
  • Pradyumna Oak,
  • Akshay Lakhotia,
  • Yogesh Godge,
  • Vyankatesh Bolegave,
  • Darshan Doshi,
  • Yogesh Patidar,
  • Anil Venkatachalam,
  • Bhavin Pujara,
  • Sandeep Borse,
  • Prashant Makhija,
  • Satish Khadilkar

DOI
https://doi.org/10.4103/aian.AIAN_1303_20
Journal volume & issue
Vol. 24, no. 3
pp. 339 – 346

Abstract

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Background: Guillian--Barre' Syndrome (GBS) has been shown to be associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The aim of our study was to study the clinical profile and outcomes of GBS in COVID-19 from the Western region of India, the State of Maharashtra. Methods: This was a retrospective, multicenter observation study from different hospitals in Maharashtra beginning from March 2020 until November 2020. Results: We report 42 patients with COVID-19 GBS. Mean age was 59 years (range, 24--85 years). 31/42 (73.8%) were men. GBS was the presenting symptom in 14/42 (33%), while six of them remained asymptomatic for COVID-19 despite positive SARS-CoV-2 on nasopharyngeal swab reverse transcriptase polymerase chain reaction. The median interval between COVID-19 and GBS was 14 days (SD + 11), with minimum of 1 and maximum 40 days. Clinical presentation was like that of typical GBS. Electrophysiological studies showed a predominant demyelinating pattern in 25/42 (59.5%). Inflammatory markers were elevated in 35/42 (83.3%) and 38/42 (90.5%) had an Abnormal high-resolution CT (HRCT) chest. 14/42 (33.3%) patients required a ventilator, with nine deaths. Intravenous immunoglobulin was the mainstay of treatment for GBS. Majority had a good outcome and were walking independently or with minimal support at discharge. In subgroup analysis, the postinfectious group had a better outcome than the parainfectious group. Conclusion: GBS in COVID-19 occurs as both parainfectious and postinfectious GBS. Parainfectious GBS needs more rigorous monitoring and may benefit from COVID-19 specific treatment. Routine screening for SARS-CoV-2 should be implemented in patients with GBS in view of the ongoing pandemic.

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