Sireesha Yareeda, Shree Ritu, Nagappa Madhu, Patil Anuja, Singla Monika, Padma Srivastava M V, Dhamija R K, Balaram Neetha, Pathak Abhishek, Ramachandran Dileep, Kumar Sujit, Puri Inder, Sharma Sudhir, Panda Samhita, Desai Soaham, Samal Priyanka, Choudhary Aditya, Vijaya Pamidimukkala, Ferreira Teresa, Nair S S, Sinha H P, Bhoi S K, Sebastian Joseph, Sharma Sanjay, Basheer Aneesh, Bhartiya Manish, Mathukumalli N L, Jabeen Shaikh Afshan, Lal Vivek, Modi Manish, Sharma P Praveen, Kaul Subash, Singh Gagandeep, Agarwal Ayush, Garg Divyani, Jose James, Dev Priya, Iype Thomas, Gopalakrishnan Maya, Upadhyay Ashish, Bhatia Rohit, Pandit Awadh K, Singh Rajesh K, Salunkhe Manish, Yogeesh P M, Reyaz Alisha, Nadda Nishant, Jha Menkha, Kumar Bismay, Kushwaha P K, Chovatiya Harshadkumar, Madduluri Bhavani, Ramesh P, Goel Abeer, Yadav Rahul, Vishnu Venugopalan Y
Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Ann Indian Acad Neurol. 2022 Nov-Dec;25(6):1116-1121. doi: 10.4103/aian.aian_523_22. Epub 2022 Dec 3.
INTRODUCTION/AIMS: Studies conducted during the coronavirus disease 2019 (COVID-19) pandemic have reported varied data regarding the incidence of Guillain-Barre syndrome (GBS). The present study investigated demographic and clinical features, management, and outcomes of patients with GBS during a specified period of the COVID-19 pandemic, and compared these features to those of GBS in the previous year.
A multicenter, ambispective cohort study including 26 centers across India was conducted. Data from a pre-COVID-19 period (March 1 to August 31, 2019) were collected retrospectively and collected ambispectively for a specified COVID-19 period (March 1 to August 31, 2020). The study was registered with the Clinical Trial Registry India (CTRI/2020/11/029143).
Data from 555 patients were included for analysis: pre-COVID-19 ( = 334) and COVID-19 ( = 221). Males were more commonly affected during both periods (male:female, 2:1). Gastroenteritis was the most frequent antecedent event in 2019 (17.4%), whereas fever was the most common event in 2020 (10.7%). Paraparesis (21.3% versus [vs.] 9.3%, = 0.001) and sensory involvement (51.1% vs. 41.3%; = 0.023) were more common during COVID-19 in 2020, whereas back pain (26.3% vs. 18.4%; = 0.032) and bowel symptoms (20.7% vs. 13.7%; = 0.024) were more frequent in the pre-COVID period. There was no difference in clinical outcomes between the two groups in terms of GBS disability score at discharge and 3 months after discharge. Independent predictors of disability in the pre-COVID period included areflexia/hyporeflexia, the requirementfor intubation, and time to bulbar weakness; in the COVID-19 period, independent predictors included time from onset to admission, intubation, and intubation requirement. The mortality rate was 2.3% during the entire study period (13/555 cases).
Results of this study revealed an overall reduction in the frequency of GBS during the pandemic. The lockdown likely reduced the risk for antecedent infections due to social distancing and improved hygiene, which may have resulted in the reduction of the frequency of GBS.
引言/目的：在2019年冠状病毒病（COVID-19）大流行期间开展的研究报告了关于吉兰-巴雷综合征（GBS）发病率的不同数据。本研究调查了COVID-19大流行特定时期GBS患者的人口统计学和临床特征、治疗及结局，并将这些特征与上一年GBS患者的特征进行比较。
开展了一项多中心、双向队列研究，纳入了印度各地的26个中心。回顾性收集了COVID-19之前时期（2019年3月1日至8月31日）的数据，并前瞻性收集了COVID-19特定时期（2020年3月1日至8月31日）的数据。该研究已在印度临床试验注册中心注册（CTRI/2020/11/029143）。
纳入555例患者的数据进行分析：COVID-19之前时期（n = 334）和COVID-19时期（n = 221）。两个时期男性受累更为常见（男:女为2:1）。2019年最常见的前驱事件是胃肠炎（17.4%），而2020年最常见的事件是发热（10.7%）。2020年COVID-19期间，双侧轻瘫（21.3% 对比 [vs.] 9.3%，P = 0.001）和感觉受累（51.1% 对比41.3%；P = 0.023）更为常见，而COVID-19之前时期背痛（26.3% 对比18.4%；P = 0.032）和肠道症状（20.7% 对比13.7%；P = 0.024）更为常见。两组在出院时及出院后3个月的GBS残疾评分方面临床结局无差异。COVID-19之前时期残疾的独立预测因素包括无反射/反射减弱、插管需求及延髓性肌无力出现时间；在COVID-19时期，独立预测因素包括起病至入院时间、插管及插管需求。在整个研究期间死亡率为2.3%（13/555例）。
本研究结果显示大流行期间GBS发病率总体下降。封锁措施可能因社交距离和卫生改善降低了前驱感染风险，这可能导致了GBS发病率下降。
