Background Reports of Guillain-Barre Syndrome (GBS) have emerged during the Coronavirus Disease 2019 (COVID-19) pandemic. This epidemiological and cohort study sought to investigate any causative association between COVID-19 infection and GBS. Methods The epidemiology of GBS cases reported via the UK National Immunoglobulin Database were studied from 2016-2019 and compared to cases reported during the COVID-19 pandemic. For the cohort study, members of the British Peripheral Nerve Society reported all cases of GBS during the pandemic. The clinical features, investigation findings and outcomes of COVID-19 (definite or probable) and non-COVID-19 associated GBS cases were compared. Results The UK GBS incidence from 2016-2019 was 1.65-1.88 per 100,000 people per year. GBS and COVID-19 incidence varied between regions and did not correlate (r = 0.06, 95% CI -0.56 to 0.63, p=0.86). GBS incidence fell between March and May 2020 compared to the same months of 2016-2019. Forty-seven GBS cases were included in the cohort study (13 definite, 12 probable COVID-19 and 22 non-COVID-19). There were no significant differences in the pattern of weakness, time to nadir, neurophysiology, CSF findings or outcome. Intubation was more frequent in the COVID-19+ve cohort (7/13, 54% vs 5/22, 23% in COVID negative) thought to be related directly to COVID-19 pulmonary involvement. Conclusions This study finds no epidemiological or phenotypic clues of SARS-CoV-2 being causative of GBS. GBS incidence has fallen during the pandemic which may be the influence of lockdown measures reducing transmission of GBS inducing pathogens such as Campylobacter jejuni and respiratory viruses.

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流行病学和队列研究未发现COVID-19与格林巴利综合征之间存在关联

在2019年冠状病毒病（COVID-19）大流行期间出现了格林-巴利综合症（GBS）的背景报道。这项流行病学和队列研究旨在调查COVID-19感染与GBS之间的任何因果关系。方法对2016-2019年通过英国国家免疫球蛋白数据库报告的GBS病例的流行病学进行研究，并将其与COVID-19大流行期间报告的病例进行比较。在队列研究中，英国外围神经学会的成员报告了大流行期间所有的GBS病例。比较了COVID-19（确定的或可能的）和非COVID-19相关的GBS病例的临床特征，调查结果和结局。结果2016-2019年英国GBS发生率为每10万人每年1.65-1.88。GBS和COVID-19的发生率在不同地区之间存在差异，并且不相关（r = 0.06，95％CI -0.56至0.63，p = 0.86）。与2016-2019年同期相比，GBS发病率在2020年3月至2020年5月之间下降。该队列研究包括了47例GBS病例（13例确诊，12例可能的COVID-19和22例非COVID-19）。虚弱的模式，到达最低点的时间，神经生理学，CSF的发现或结局无明显差异。在COVID-19 + ve队列中插管更为频繁（7 / 13，54％vs 5 / 22，23％，在COVID阴性中），这与COVID-19肺部受累直接相关。结论本研究没有发现SARS-CoV-2的流行病学或表型线索是GBS的病因。大流行期间GBS发病率下降，这可能是锁定措施的影响，该措施减少了GBS诱导的病原体如空肠弯曲菌和呼吸道病毒的传播。与2016-2019年同期相比，GBS发病率在2020年3月至2020年5月之间下降。该队列研究包括了47例GBS病例（13例确诊，12例可能的COVID-19和22例非COVID-19）。虚弱的模式，到达最低点的时间，神经生理学，CSF的发现或结局无明显差异。在COVID-19 + ve队列中插管更为频繁（7 / 13，54％vs 5 / 22，23％，在COVID阴性中），这与COVID-19肺部受累直接相关。结论本研究没有发现SARS-CoV-2的流行病学或表型线索是GBS的病因。大流行期间GBS发病率下降，这可能是锁定措施的影响，该措施减少了GBS诱导的病原体如空肠弯曲菌和呼吸道病毒的传播。与2016-2019年同期相比，GBS发病率在2020年3月至2020年5月之间下降。队列研究包括了47例GBS病例（13例确诊，12例可能的COVID-19和22例非COVID-19）。虚弱的模式，到达最低点的时间，神经生理学，CSF的发现或结局无明显差异。在COVID-19 + ve队列中插管更为频繁（7 / 13，54％vs 5 / 22，23％，在COVID阴性中），这与COVID-19肺部受累直接相关。结论本研究没有发现SARS-CoV-2的流行病学或表型线索是GBS的病因。大流行期间GBS发病率下降，这可能是锁定措施的影响，该措施减少了GBS诱导的病原体（如空肠弯曲菌和呼吸道病毒）的传播。