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Guillian--Barre' syndrome in patients with SARS-CoV-2: A multicentric study from Maharashtra, India
Annals of Indian Academy of Neurology ( IF 1.7 ) Pub Date : 2021-05-01 , DOI: 10.4103/aian.aian_1303_20
Megha C Dhamne 1 , Rajesh Benny 2 , Rakesh Singh 2 , Amitkumar Pande 3 , Pankaj Agarwal 4 , Satish Wagh 5 , Pradyumna Oak 6 , Akshay Lakhotia 7 , Yogesh Godge 8 , Vyankatesh Bolegave 9 , Darshan Doshi 10 , Yogesh Patidar 11 , Anil Venkatachalam 12 , Bhavin Pujara 13 , Sandeep Borse 14 , Prashant Makhija 15 , Satish Khadilkar 16
Affiliation  


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.


中文翻译:

SARS-CoV-2 患者的 Guillian-Barre' 综合征:印度马哈拉施特拉邦的多中心研究


背景: Guillian-Barre' 综合征 (GBS) 已被证明与严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染有关。我们研究的目的是研究印度西部地区马哈拉施特拉邦在 COVID-19 中 GBS 的临床特征和结果。方法:这是一项从 2020 年 3 月到 2020 年 11 月在马哈拉施特拉邦不同医院开展的回顾性、多中心观察研究。结果:我们报告了 42 名 COVID-19 GBS 患者。平均年龄为 59 岁(范围为 24--85 岁)。31/42 (73.8%) 是男性。GBS 是 14/42 (33%) 的主诉症状,尽管鼻咽拭子逆转录酶聚合酶链反应中 SARS-CoV-2 呈阳性,但其中 6 人仍无 COVID-19 症状。COVID-19 和 GBS 之间的中位间隔为 14 天 (SD + 11),最短为 1 天,最长为 40 天。临床表现与典型 GBS 相似。电生理学研究显示 25/42 (59.5%) 中主要的脱髓鞘模式。35/42 (83.3%) 的炎症标志物升高,38/42 (90.5%) 的胸部高分辨率 CT (HRCT) 异常。14/42 (33.3%) 的患者需要呼吸机,其中 9 人死亡。静脉注射免疫球蛋白是治疗GBS的主要方法。大多数人有良好的结果,并且在出院时可以独立行走或在最小的支持下行走。在亚组分析中,感染后组的结果优于副感染组。结论: COVID-19 中的 GBS 以副感染性和感染后 GBS 的形式出现。副感染性 GBS 需要更严格的监测,并可能受益于 COVID-19 的特异性治疗。鉴于持续的大流行,应对 GBS 患者进行 SARS-CoV-2 常规筛查。
更新日期:2021-05-01
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