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Clinical and Electrodiagnostic Characteristics of COVID-19-Associated Guillain-Barré Syndrome: A Multicenter Study
Nermin Gorkem Sirin1, Volkan Tasdemir1, Arman Cakar1
1Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Background:
This study aimed to define the clinical and electrodiagnostic characteristics of COVID-19-associated Guillain-Barré syndrome (C + GBS) diagnosed during a multicenter GBS study performed in Istanbul.
Methods:
From the patients with GBS who were prospectively included in the multicenter study conducted from April 2019 to March 2022, two groups were extracted: (1) pre-pandemic patients (PP, April 2019-February 2020); and (2) C + GBS, consisting of patients with a positive COVID-19 polymerase chain reaction test within 4-6 weeks before the onset of symptoms. Clinical features and electrodiagnostic data acquired twice in the first 21 days of GBS and between the 4th and 6th weeks of the illness were compared between the groups.
Results:
There were 22 patients in the C + GBS and 69 in the PP groups. Patients with C + GBS were older than those in the PP group (58.9 ± 15.4 vs. 49.8 ± 17.5, p = 0.047). Motor signs/symptoms were more prevalent in the C + GBS group than in the PP group. In the C + GBS group, demyelinating subtype was significantly more frequent (82% vs. 52%, p = 0.031), and CSF cell count was lower (0.8 ± 1.8 vs. 5.7 ± 11.7 cells/all, p = 0.007) compared with the PP group. The clinical severity scores, treatment strategies and the time from the symptom onset to the nadir did not differ between the groups. None of the C + GBS patients, except one, had anti-ganglioside antibodies. The only significant parameter was the demyelinating subtype in the multivariate analysis.
Conclusion:
Patients with C + GBS seemed to show a predominantly demyelinating subtype with no discernible differences in clinical features.
