We diagnosed 11 Guillain–Barré syndrome (GBS) cases among 71,904 COVID patients attended at 61 Spanish emergency departments (EDs) during the 2‐month pandemic peak. The relative frequency of GBS among ED patients was higher in COVID (0.15‰) than non‐COVID (0.02‰) patients (odds ratio [OR] = 6.30, 95% confidence interval [CI] = 3.18–12.5), as was the standardized incidence (9.44 and 0.69 cases/100,000 inhabitant‐years, respectively, OR = 13.5, 95% CI = 9.87–18.4). Regarding clinical characteristics, olfactory–gustatory disorders were more frequent in COVID‐GBS than non‐COVID–GBS (OR = 27.59, 95% CI = 1.296–587) and COVID–non‐GBS (OR = 7.875, 95% CI = 1.587–39.09) patients. Although COVID‐GBS patients were more frequently admitted to intensive care, mortality was not increased versus control groups. Our results suggest SARS‐CoV‐2 could be another viral infection causing GBS. ANN NEUROL 2021;89:598–603

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The identification of CYP2C9 and VKORC1 genes has strongly stimulated the research on pharmacogenetics of coumarins in the last decade. We assessed the combined influence of CYP2C9 *2 and *3, and VKORC1 c.-1639G>A, 497C>G, and 1173C>T variants, on acenocoumarol dosage using a novel algorithm approach, in 193 outpatients who had achieved stable anticoagulation. We constructed an “acenocoumarol-dose genotype score” (AGS, maximum score = 100) based on the number of alleles associated with higher acenocoumarol dosage carried by each subject for each polymorphism. The mean AGS was higher in the high-dose (>28mg/week) compared with the low-dose (<7mg/week) group (mean(SEM) of 84.1±3.4 vs. 62.2±4.8, P = 0.008). An AGS>70 was associated with an increased odds ratio (OR) of requiring high acenocoumarol dosage (OR: 3.347; 95%CI: 1.112–10.075; P = 0.032). In summary, although more research is necessary in other patient cohorts, and this algorithm should be replicated in an independent sample, our data suggest that the AGS algorithm could be used to help discriminating patients requiring high acenocoumarol doses to achieve stable anti-coagulation.

A series of factors is associated with prolonged length of hospital stay and should be taken into account in the management of acute heart failure.

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