Volume 25, Issue 4 pp. 335-343
REVIEW

Guillain-Barré syndrome associated with SARS-CoV-2 infection: A systematic review and individual participant data meta-analysis

Imran Hasan

Imran Hasan

Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division, icddr,b, Dhaka, Bangladesh

Search for more papers by this author
KM Saif-Ur-Rahman

KM Saif-Ur-Rahman

Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh

Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan

Search for more papers by this author
Shoma Hayat

Shoma Hayat

Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division, icddr,b, Dhaka, Bangladesh

Search for more papers by this author
Nowshin Papri

Nowshin Papri

Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division, icddr,b, Dhaka, Bangladesh

Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands

Search for more papers by this author
Israt Jahan

Israt Jahan

Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division, icddr,b, Dhaka, Bangladesh

Search for more papers by this author
Rufydha Azam

Rufydha Azam

Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division, icddr,b, Dhaka, Bangladesh

Search for more papers by this author
Gulshan Ara

Gulshan Ara

Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh

Search for more papers by this author
Zhahirul Islam

Corresponding Author

Zhahirul Islam

Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division, icddr,b, Dhaka, Bangladesh

Correspondence

Dr. Zhahirul Islam, PhD, Laboratory of Gut-Brain Signaling, Laboratory Sciences and Services Division, icddr,b, 68, Shaheed Tajuddin Ahmad Sarani, Mohakhali, Dhaka 1212, Bangladesh.

Email: [email protected]

Search for more papers by this author
First published: 28 October 2020
Citations: 48
Imran Hasan and KM Saif-Ur-Rahman contributed equally to this study.

Abstract

Several published reports have described a possible association between Guillain-Barré syndrome (GBS) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This systematic review aimed to summarize and meta-analyze the salient features and prognosis of SARS-CoV-2-associated GBS. We searched the PubMed (Medline), Web of Science and Cochrane databases for articles published between 01 January 2020 and 05 August 2020 using SARS-CoV-2 and GBS-related keywords. Data on sociodemographic characteristics, antecedent symptoms, clinical, serological and electrophysiological features, and hospital outcomes were recorded. We included 45 articles from 16 countries reporting 61 patients with SARS-CoV-2-associated GBS. Most (97.7%) articles were from high- and upper-middle-income countries. Forty-two (68.9%) of the patients were male; median (interquartile range) age was 57 (49-70) years. Reverse transcriptase polymerase chain reaction for SARS-CoV-2 was positive in 90.2% of patients. One report of SARS-CoV-2-associated familial GBS was found which affected a father and daughter of a family. Albuminocytological dissociation in cerebrospinal fluid was found in 80.8% of patients. The majority of patients (75.5%) had a demyelinating subtype of GBS. Intravenous immunoglobulin and plasmapheresis were given to 92.7% and 7.3% of patients, respectively. Around two-thirds (65.3%) of patients had a good outcome (GBS-disability score ≤ 2) on discharge from hospital. Two patients died in hospital. SARS-CoV-2-associated GBS mostly resembles the classical presentations of GBS that respond to standard treatments. Extensive surveillance is required in low- and lower-middle-income countries to identify and report similar cases/series. Further large-scale case-control studies are warranted to strengthen the current evidence. PROSPERO Registration Number CRD42020201673.

CONFLICT OF INTERESTS

Zhahirul Islam received grants from the Fogarty International Center, National Institute of Neurological Disorders and Stroke of the National Institutes of Health, USA under Award Number K43 TW011447 and Annexon Biosciences (South San Francisco, CA 94080, USA). The other authors do not have any conflict of interests.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.