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与新冠疫苗接种相关的吉兰-巴雷综合征的预后

Prognosis of Guillain-Barré Syndrome Linked to COVID-19 Vaccination.

作者信息

Chua Shaun Kai Kiat, Soh Qian Ying, Saffari Seyed Ehsan, Tan Eng-King

机构信息

Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Rd, Singapore 30832, Singapore.

National Neuroscience Institute, Duke NUS Medical School, Outram Rd, Singapore 169608, Singapore.

出版信息

Brain Sci. 2022 May 30;12(6):711. doi: 10.3390/brainsci12060711.

Abstract

There have been increasing reports of Guillain-Barré syndrome (GBS), a rare but debilitating neurological disease, occurring post-COVID-19 vaccination. However, the outcomes and relationships between patient demographics and clinical outcomes of post-COVID-19 vaccination GBS remain unclear. To bridge this gap, our study investigates the outcomes and clinical factors associated with poorer GBS outcomes following COVID-19 vaccination. We conducted a review and pooled analysis of detailed data extracted from 57 published cases with the relevant search strategies and criteria. The groups compared included male versus female patients, 1st dose versus 2nd dose and early onset versus late onset of GBS. Multivariate regression analysis was performed to compare the vaccine type, clinical severity and post-treatment outcomes between these groups of patients. Our results highlight for the first time that females were significantly more likely to have severe clinical presentation and poorer outcomes compared to males. Additionally, viral vector vaccines were the predominant vaccine type administered in early-onset post-COVID-19-vaccination GBS and GBS occurring after the 1st vaccination dose. It was also shown that reported cases of post-vaccination GBS generally displayed a positive response to conventional treatment and had favourable post-treatment outcomes. Through this study, we have established important links and provided assuring evidence for treatment response and post-treatment outcomes of GBS occurring post-COVID-19 vaccination. While the COVID-19 vaccination brings about much greater benefits than risks, our findings provide further impetus for greater vigilance in certain patient groups and more studies to explore the mechanisms behind these links.

摘要

越来越多的报告称,吉兰-巴雷综合征(GBS)这种罕见但使人衰弱的神经系统疾病在新冠疫苗接种后出现。然而,新冠疫苗接种后GBS患者的人口统计学特征与临床结果之间的关系以及结果仍不明确。为了填补这一空白,我们的研究调查了新冠疫苗接种后GBS预后较差的相关结果和临床因素。我们对通过相关检索策略和标准从57例已发表病例中提取的详细数据进行了综述和汇总分析。比较的组包括男性与女性患者、第1剂与第2剂疫苗接种、GBS的早发与晚发。进行多变量回归分析以比较这些患者组之间的疫苗类型、临床严重程度和治疗后结果。我们的结果首次强调,与男性相比,女性更有可能出现严重的临床表现和较差的预后。此外,病毒载体疫苗是新冠疫苗接种后早发性GBS和第1剂疫苗接种后发生GBS中使用的主要疫苗类型。研究还表明,报告的疫苗接种后GBS病例通常对传统治疗有阳性反应,且治疗后结果良好。通过这项研究,我们建立了重要联系,并为新冠疫苗接种后发生的GBS的治疗反应和治疗后结果提供了可靠证据。虽然新冠疫苗接种带来的益处远大于风险,但我们的研究结果为提高对某些患者群体的警惕性以及开展更多研究以探索这些联系背后的机制提供了进一步的动力。

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