Pimentel Vitória, Luchsinger Vanessa Wallau, Carvalho Gabriel Leal, Alcará Allan Marinho, Esper Nathalia Bianchini, Marinowic Daniel, Zanirati Gabriele, da Costa Jaderson Costa
Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
Undergraduate Research Program, School of Medicine and Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
Brain Behav Immun Health. 2023 Mar;28:100578. doi: 10.1016/j.bbih.2022.100578. Epub 2023 Jan 17.
With the outbreak of coronavirus disease 2019 (COVID-19), the whole world was impacted by a pandemic. With the passage of time and knowledge about the dynamics and viral propagation of this disease, the short-, medium- and long-term repercussions are still being discovered. During this period, it has been learned that various manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect the nervous system. In recent months, a variety of studies and case reports have proposed an association between COVID-19 and Guillain-Barré syndrome (GBS). The present work aims to systematically review the publications available to date to verify the relationship between these two pathologies and the characteristics of post-COVID GBS. There were 156 studies included in this work, resulting in a total of 436 patients. The findings show a mean age of the patients of 61,38 years and a male majority. The GBS symptoms began on average 19 days after the onset of COVID-19 infection. Regarding GBS, the main manifestations found included generalized weakness, reflex reduction, facial paresis/paralysis and hypoesthesia. As expected, the most common result in cerebrospinal fluid (CSF) analysis was albuminocytological dissociation. A pattern of blood analysis findings common to all patients was not observed due to non-standardization of case reports. Regarding electrodiagnostic studies, acute inflammatory demyelinating polyneuropathy (AIDP) appeared as the most common subtype of GBS in this study. There have been reports, to a lesser extent, of acute motor axonal neuropathy (AMAN), acute sensorimotor axonal neuropathy (AMSAN), the pharyngeal-cervical-brachial variant (PCB), and Miller-Fisher syndrome (MFS). The GBS treatment used was mainly intravenous immunoglobulin (IVIG) and plasma exchange (PLEX). Therefore, the present study reports a high prevalence of hospitalization and intensive care units ICU admissions, conjecturing a relationship between the development of GBS and the severity of COVID-19. Despite the severity, most patients showed improvement in GBS symptoms after treatment, and their residual symptoms did not include motor involvement. Therefore, the development of GBS seems to be related to COVID-19 infection, as reported by the present systematic review.
随着2019冠状病毒病（COVID-19）的爆发，全球受到了一场大流行病的影响。随着时间的推移以及对这种疾病的动态变化和病毒传播的了解，其短期、中期和长期影响仍在不断被发现。在此期间，人们了解到严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的各种表现可影响神经系统。近几个月来，各种研究和病例报告提出了COVID-19与吉兰-巴雷综合征（GBS）之间的关联。本研究旨在系统回顾迄今为止的相关文献，以验证这两种疾病之间的关系以及COVID-19后GBS的特征。本研究纳入了156项研究，共计436例患者。研究结果显示，患者的平均年龄为61.38岁，男性居多。GBS症状平均在COVID-19感染发病后19天出现。关于GBS，发现的主要表现包括全身无力、反射减弱、面部轻瘫/瘫痪和感觉减退。不出所料，脑脊液（CSF）分析中最常见的结果是蛋白细胞分离。由于病例报告未标准化，未观察到所有患者共同的血液分析结果模式。关于电诊断研究，急性炎症性脱髓鞘性多发性神经病（AIDP）在本研究中似乎是GBS最常见的亚型。在较小程度上，也有急性运动轴索性神经病（AMAN）、急性感觉运动轴索性神经病（AMSAN）、咽颈臂型变异型（PCB）和米勒-费希尔综合征（MFS）的报告。所采用的GBS治疗方法主要是静脉注射免疫球蛋白（IVIG）和血浆置换（PLEX）。因此，本研究报告了住院和入住重症监护病房（ICU）的高发生率，推测GBS的发生与COVID-19的严重程度之间存在关联。尽管病情严重，但大多数患者在治疗后GBS症状有所改善，且其残留症状不包括运动受累。因此，正如本系统综述所报告的，GBS的发生似乎与COVID-19感染有关。
