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Association Between Guillain-Barré Syndrome and COVID-19 Infection and Vaccination: A Population-Based Nested
Haya Bishara1, Anat Arbel2, Ofra Barnett-Griness1
1From the Department of Neurology (H.B., S.B.), and Department of Internal Medicine B (A.A., S.C.), Lady Davis Carmel Medical Center; Ruth and Bruce Rappaport Faculty of Medicine (A.A., S.B., S.C., R.N.-D., N.G., W.S.), Technion-Israel Institute of Technology; Statistical Unit (O.B.-G., W.S.), Department of Community Medicine and Epidemiology (O.B.-G., N.G.), and Infection Control and Prevention Unit (R.N.-D.), Lady Davis Carmel Medical Center, Haifa; Sackler Faculty of Medicine (E.A.), Tel Aviv University; Department of Neurology (E.A.), Rabin Medical Center, Petach Tikva; and Translational Epidemiology Unit and Research Authority (W.S.), Lady Davis Carmel Medical Center, Haifa, Israel.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increases Guillain-Barré syndrome (GBS) risk, while the Pfizer-BioNTech COVID-19 vaccine appears to decrease GBS risk. Further research is needed to confirm these findings.
Area of Science:
- Neurology
- Epidemiology
- Vaccinology
Background:
- Inconclusive data exists on Guillain-Barré syndrome (GBS) occurrence post-COVID-19 infection and vaccination.
- Assessing the association between GBS and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 vaccination is crucial.
Purpose of the Study:
- To evaluate the association between GBS and SARS-CoV-2 infection.
- To determine the association between GBS and COVID-19 vaccination.
Main Methods:
- A nested case-control study was conducted on 3,193,951 patients aged 16+ without prior GBS diagnosis.
- Cases of GBS were matched with 10 controls based on age and sex.
- Exposure to SARS-CoV-2 infection and COVID-19 vaccination within the prior 6 weeks was assessed.
Main Results:
- A significantly increased odds ratio for GBS was found associated with SARS-CoV-2 infection (OR 6.30).
- A significantly decreased odds ratio for GBS was associated with the Pfizer-BioNTech COVID-19 vaccine (OR 0.41).
- Results remained consistent across different exposure ascertainment windows (4 and 8 weeks).
Conclusions:
- SARS-CoV-2 infection is linked to an elevated risk of developing GBS.
- The Pfizer-BioNTech COVID-19 vaccine may be associated with a reduced risk of GBS.
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