Gupta Anupam, Ranga Anurag, Prakash Naveen B, Khanna Meeka
Department of Neurological Rehabilitation, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
J Neurosci Rural Pract. 2022 Oct-Dec;13(4):684-690. doi: 10.25259/JNRP-2022-6-26. Epub 2022 Dec 2.
With COVID-19 vaccination campaign worldwide, associated Guillain-Barre syndrome (GBS) is being increasingly reported from different countries. The objectives of the study were to observe the clinical profile and rehabilitation outcomes in patients with post-COVID-19 vaccine-associated GBS.
This prospective study was conducted in neurological rehabilitation unit with in-patients. A detailed customized rehabilitation program was formulated based on the clinical status and associated complications. Outcome measures were documented on the day of admission and at discharge and compared.
The study included 16 patients (eight males) of which 15 (93.75%) received the CoviShield (AstraZeneca) and 1 Covaxin (Bharat Biotech) vaccine. The median (IQR) duration of first symptom was 9 (18.25) days and for motor symptoms 18 (12.75) days. Functional improvement was observed in patients using Barthel index scores and Hughes disability scores and overall neuropathy limitation scale. All rehabilitation outcomes showed a statistically significant improvement ( < 0.05) from the time of admission to discharge. At discharge, complete independence in activities of daily living was achieved in 4 (25%) patients and 5 (31.25%) were minimally dependent. Three (18.75%) patients were walking independently, seven (43.75%) with minimal support, and four with walker (25%). Nine (56.25%) patients needed bilateral ankle-foot orthosis and two bilateral knee gaiters for locomotion.
Comprehensive inpatient rehabilitation interventions in patients with post-COVID-19 vaccine-associated GBS result in significant functional recovery.
随着全球范围内开展新冠病毒疫苗接种运动，不同国家越来越多地报告了与之相关的吉兰-巴雷综合征（GBS）。本研究的目的是观察新冠病毒疫苗相关GBS患者的临床特征和康复结局。
本前瞻性研究在神经康复科对住院患者进行。根据临床状况和相关并发症制定了详细的定制康复计划。在入院当天和出院时记录结局指标并进行比较。
该研究纳入了16例患者（8例男性），其中15例（93.75%）接种了科维希德（阿斯利康）疫苗，1例接种了科瓦克辛（巴拉特生物技术公司）疫苗。首发症状的中位（四分位间距）持续时间为9（18.25）天，运动症状的持续时间为18（12.75）天。使用巴氏指数评分、休斯残疾评分和总体神经病变限制量表观察到患者功能有所改善。从入院到出院，所有康复结局均显示出统计学上的显著改善（<0.05）。出院时，4例（25%）患者在日常生活活动中实现了完全独立，5例（31.25%）患者为轻度依赖。3例（18.75%）患者能够独立行走，7例（43.75%）患者需要最小程度的支撑，4例患者使用助行器（25%）。9例（56.25%）患者行走时需要双侧踝足矫形器，2例需要双侧膝关节护具。
对新冠病毒疫苗相关GBS患者进行全面的住院康复干预可导致显著的功能恢复。
