Childhood <scp>Guillain–Barre</scp> syndrome in the <scp>SARS‐CoV</scp>‐2 era: Is there any causative relation?

Pourbakhtyaran, Elham; Heidari, Morteza; Akbari, Masood Ghahvechi; Mohammadi, Mahmoud; Badv, Reza Shervin; Zamani, Gholamreza; Tavasoli, Ali Reza; Rezaei, Zahra; Mamishi, Setareh; Memar, Elmira Haji Esmaeil; Hosseiny, Seyyed Mohammad Mahdi; Ghabeli, Homa; Haghighi, Ramin; Ashrafi, Mahmoud Reza

doi:10.1002/ccr3.6772

Cited by 4 publications

(11 citation statements)

References 14 publications

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“…To the Editor, We read with interest the article by Pourbahtyaran et al about a prospective study on seven pediatric patients with SARS-CoV-2-associated Guillain Barre syndrome (GBS) recruited between March 2020 and August 2021 in a single Iranian center. 1 These patients were compared with 15 GBS patients who were negative for SARS-CoV-2 mRNA as well as antibodies recruited during the same period. 1 It was found that the prevalence of GBS did not increase during the pandemic compared with previous years but that the outcome of SARS-CoV-2-related GBS was worse compared with non-COVID-related GBS.…”

Section: Sars-cov-2-related Polyradiculitis Must Be Preceded By Pcr-c...mentioning

confidence: 99%

“… 1 It was found that the prevalence of GBS did not increase during the pandemic compared with previous years but that the outcome of SARS‐CoV‐2‐related GBS was worse compared with non‐COVID‐related GBS. 1 The study is appealing but carries limitations that raise concerns and should be discussed.…”

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confidence: 92%

“… 1 These patients were compared with 15 GBS patients who were negative for SARS‐CoV‐2 mRNA as well as antibodies recruited during the same period. 1 It was found that the prevalence of GBS did not increase during the pandemic compared with previous years but that the outcome of SARS‐CoV‐2‐related GBS was worse compared with non‐COVID‐related GBS. 1 The study is appealing but carries limitations that raise concerns and should be discussed.…”

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confidence: 99%

“…The main limitation of the study is that SARS‐CoV‐2 infection was diagnosed in six patients with SARS‐CoV‐2‐related GBS only by determination of antibodies against SARS‐CoV‐2. 1 It was not communicated whether these antibodies were of the IgG or IgM subtype. 1 It was also not discussed that these antibodies can persist for months, why establishing a causal relationship between SARS‐CoV‐2 infection and GBS is not reliable in these six patients.…”

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confidence: 99%

“… 1 It was not communicated whether these antibodies were of the IgG or IgM subtype. 1 It was also not discussed that these antibodies can persist for months, why establishing a causal relationship between SARS‐CoV‐2 infection and GBS is not reliable in these six patients. They should be excluded from the evaluation.…”

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confidence: 99%

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SARS‐CoV‐2‐related polyradiculitis must be preceded by PCR‐confirmed COVID‐19

Finsterer¹

2023

Clinical Case Reports

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Section: Sars-cov-2-related Polyradiculitis Must Be Preceded By Pcr-c...mentioning

confidence: 99%

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confidence: 92%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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SARS‐CoV‐2‐related polyradiculitis must be preceded by PCR‐confirmed COVID‐19

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2023

Clinical Case Reports

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Guillain−Barré syndrome and SARS‐CoV‐2 infection: a systematic review and meta‐analysis on a debated issue and evidence for the ‘Italian factor’

Censi,

Bisaccia,

Gallina

et al. 2023

Euro J of Neurology

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Background and purposeThe association between Guillain−Barré syndrome (GBS) and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is debated. This study reappraises, after three pandemic years, the epidemiological data and the features of GBS in SARS‐CoV‐2 patients.MethodsA systematic review and meta‐analysis of case reports/series and cohort studies published between 1 January 2020 and 19 April 2023 was performed.ResultsIn all, 209 case reports/series (304 patients) and 26 cohort studies were included. The risk of GBS in northern Italy during the first pandemic wave was 2.85 times increased (95% confidence interval [CI] 1.54; 5.25) whereas in some countries the risk during the first pandemic year was 0.17 times reduced (risk ratio 0.83, 95% CI 0.75; 0.93). The incidence of GBS in SARS‐CoV‐2 Italian hospitalized cohorts was 8.55 per 1000 (95% CI 5.33; 12.49) with an estimated incidence of 0.13 GBS per 1000 in the SARS‐CoV‐2 infected population. In European cohorts the pooled rate of GBS with SARS‐CoV‐2 infection was 61.3% of the total. GBS patients with SARS‐CoV‐2 infection showed more frequently, but not differently from non‐infected patients, the classical clinical presentation and the demyelinating subtype. Cranial nerves were more frequently involved in SARS‐CoV‐2 infected patients.ConclusionsAn increased risk of GBS occurred in northern Italy during early COVID‐19 pandemic. The recognition of the ‘Italian factor’ reconciles contrasting results of the epidemiological studies. The slightly reduced GBS risk in other countries and the relatively high frequency of GBS associated with SARS‐CoV‐2 infection can be explained by the adopted health measures that decreased the circulation of other GBS infective antecedents.

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Neurological consequences of SARS-CoV-2 infections in the pediatric population

et al. 2023

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COVID-19 in the pediatric population is mostly asymptomatic. However, 1 out of 5 children presents non-specific neurologic symptoms such as headache, weakness, or myalgia. Furthermore, rarer forms of neurological diseases are increasingly being described in association to a SARS-CoV-2 infection. Encephalitis, stroke, cranial nerves impairment, Guillain-Barré syndrome or acute transverse myelitis have been reported and account for around 1% of pediatric COVID-19 cases. Some of these pathologies may occur during or after the SARS-CoV-2 infection. The pathophysiological mechanisms range from direct invasion of the central nervous system (CNS) by SARS-CoV-2 itself to postinfectious immune-mediated CNS inflammation. In most cases, patients presenting neurological pathologies related to SARS-CoV-2 infection are at greater risk of life-threatening complications and should be closely monitored. Further studies are needed to acknowledge the potential long-term neurodevelopmental consequences of the infection.

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Childhood Guillain–Barre syndrome in the SARS‐CoV‐2 era: Is there any causative relation?

Cited by 4 publications

References 14 publications

SARS‐CoV‐2‐related polyradiculitis must be preceded by PCR‐confirmed COVID‐19

SARS‐CoV‐2‐related polyradiculitis must be preceded by PCR‐confirmed COVID‐19

Guillain−Barré syndrome and SARS‐CoV‐2 infection: a systematic review and meta‐analysis on a debated issue and evidence for the ‘Italian factor’

Neurological consequences of SARS-CoV-2 infections in the pediatric population

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