Garg Divyani, Dhamija Rajinder K, Choudhary Aditya, Shree Ritu, Kumar Sujit, Samal Priyanka, Pathak Abhishek, Vijaya Pamidimukkala, Sireesha Yareeda, Nair Sruthi S, Sharma Sanjay, Desai Soaham, Sinha Human P, Agarwal Ayush, Upadhyay Ashish, Padma Srivastava M V, Bhatia Rohit, Pandit Awadh K, Singh Rajesh K, Reyaz Alisha, Yogeesh P M, Salunkhe Manish, Lal Vivek, Modi Manish, Singh Gagandeep, Singla Monika, Panda Samhita, Gopalakrishnan Maya, Puri Inder, Sharma Sudhir, Kumar Bismay, Kushwaha Prashant K, Chovatiya Harshadkumar, Ferreira Teresa, Bhoi Sanjeev K, Bhartiya Manish, Kaul Subhash, Patil Anuja, Mathukumalli Neeharika L, Nagappa Madhu, Sharma P Praveen, Basheer Aneesh, Ramachandran Dileep, Balaram Neetha, Sebastian Jospeh, Vishnu Venugopalan Y
Department of Neurology, Lady Hardinge Medical College, New Delhi, India.
Department of Neurology, Apollo Gleneagles Hospitals, Kolkata, West Bengal, India.
Ann Indian Acad Neurol. 2022 Jan-Feb;25(1):60-67. doi: 10.4103/aian.aian_392_21. Epub 2021 Nov 17.
To study impact of COVID-19 pandemic on frequency, clinical/electrophysiological profile and treatment outcomes in pediatric Guillain-Barré syndrome (GBS).
GBS is the most frequent cause of pediatric acute flaccid paralysis. The effect of the COVID-19 pandemic on pediatric GBS is unclear in the literature.
We conducted an ambispective, multicentric, cohort study involving 12 of 27 centres in GBS Consortium, during two periods: pre-COVID-19 (March-August 2019) and during COVID-19 (March-August 2020). Children ≤12 years who satisfied National Institute of Neurological Diseases and Stroke criteria for GBS/variants were enrolled. Details pertaining to clinical/laboratory parameters, treatment and outcomes (modified Rankin Scale (mRS) at discharge, GBS Disability score at discharge and 3 months) were analysed.
We enrolled 33 children in 2019 and 10 in 2020. Children in 2020 were older (median 10.4 [interquartile range 6.75-11.25] years versus 5 (2.5-8.4) years; = 0.022) and had more sensory symptoms (50% versus 18.2%; = 0.043). The 2020 group had relatively favourable mRS at discharge (median 1 (1-3.5) versus 3 (2-4); = 0.042) and GBS disability score at 3 months (median 0 (0-0.75) versus 2 (0-3); = 0.009) compared to 2019. Multivariate analysis revealed bowel involvement ( = 0.000) and ventilatory support ( = 0.001) as independent predictors of disability. No child in 2020 had preceding/concurrent SARS-CoV2 infection.
The COVID-19 pandemic led to a marked decline in pediatric GBS presenting to hospitals. Antecedent illnesses, clinical and electrophysiological profile of GBS remained largely unchanged from the pre-pandemic era.
研究新型冠状病毒肺炎（COVID-19）大流行对儿童吉兰-巴雷综合征（GBS）的发病频率、临床/电生理特征及治疗结局的影响。
GBS是儿童急性弛缓性麻痹最常见的病因。COVID-19大流行对儿童GBS的影响在文献中尚不清楚。
我们进行了一项前瞻性、多中心队列研究，纳入了GBS联盟27个中心中的12个中心，研究分两个阶段进行：COVID-19之前（2019年3月至8月）和COVID-19期间（2020年3月至8月）。纳入符合美国国立神经疾病与中风研究所GBS/变异型标准的12岁及以下儿童。分析了与临床/实验室参数、治疗及结局（出院时改良Rankin量表（mRS）、出院时及3个月时的GBS残疾评分）相关的详细信息。
2019年我们纳入了33名儿童，2020年纳入了10名。2020年的儿童年龄更大（中位年龄10.4[四分位间距6.75 - 11.25]岁 vs 5（2.5 - 8.4）岁；P = 0.022），感觉症状更多（50% vs 18.2%；P = 0.043）。与2019年相比，2020年组出院时mRS相对较好（中位值1（1 - 3.5）vs 3（2 - 4）；P = 0.042），3个月时GBS残疾评分也较好（中位值0（0 - 0.75）vs 2（0 - 3）；P = 0.009）。多因素分析显示肠道受累（P = 0.000）和通气支持（P = 0.001）是残疾的独立预测因素。2020年没有儿童有前驱/并发严重急性呼吸综合征冠状病毒2（SARS-CoV2）感染。
COVID-19大流行导致到医院就诊的儿童GBS明显减少。GBS的前驱疾病、临床和电生理特征与大流行前时代相比基本未变。
