吉兰-巴雷综合征合并新型冠状病毒2型感染患者的残疾评估
Disability evaluation in patients with Guillain-Barre syndrome and SARS-CoV-2 infection.
作者信息
Sanchez-Boluarte Sofía S, Aguirre-Quispe Wilfor, Tacunan-Cuellar Jhon, Sanchez-Boluarte Arantxa N, Segura-Chavez Darwin
机构信息
School of Medicine, Universidad Cesar Vallejo, Trujillo, Peru.
Neurosciences, Clinical Effectiveness and Public Health Research Group, Universidad Científica del Sur, Lima, Peru.
出版信息
Front Neurol. 2023 Jun 29;14:1191520. doi: 10.3389/fneur.2023.1191520. eCollection 2023.
OBJECTIVE
Several cases of Guillain-Barre syndrome (GBS) associated with SARS-CoV-2 infection have been described. This study illustrated the demographic, clinical, and neurophysiological characteristics of patients with GBS and COVID-19, as well as associated factors with disability at discharge.
MATERIALS AND METHODS
A retrospective analytical observational study was conducted. It included patients diagnosed with GBS admitted in a national reference center in Peru between 2019 and 2021. Epidemiological, clinical, neurophysiological, and cerebrospinal fluid data were analyzed. A multivariate analysis, using the generalized linear model, was performed, considering the presence of disability at discharge as the dependent variable.
RESULTS
Eight-one subjects diagnosed with GBS were included. The mean age was 46.8 years (SD: 15.2), with a predominance of males (61.73%). The most frequent clinical presentation was the classic sensory-motor form in 74 cases (91.36%) with AIDP (82.35%) as the most frequent neurophysiological pattern in the group with COVID-19, while AMAN pattern predominated (59.26%) in those without COVID-19 ( = <0.000). The disability prevalence ratio at discharge between subjects with COVID-19 and those without COVID-19 was 1.89 (CI 1.06-3.34), = 0.030, adjusted for age, sex, and neurophysiological subtype.
CONCLUSION
The neurophysiologic subtype AIDP, and a higher disability were associated with the presence of COVID-19.
目的
已有数例与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染相关的吉兰-巴雷综合征（GBS）病例被报道。本研究阐述了GBS合并新型冠状病毒肺炎（COVID-19）患者的人口统计学、临床和神经生理学特征，以及出院时残疾的相关因素。
材料与方法
进行一项回顾性分析观察研究。纳入2019年至2021年在秘鲁一家国家参考中心收治的确诊为GBS的患者。分析其流行病学、临床、神经生理学和脑脊液数据。以出院时是否存在残疾为因变量，采用广义线性模型进行多变量分析。
结果
纳入81例确诊为GBS的患者。平均年龄为46.8岁（标准差：15.2），男性占多数（61.73%）。最常见的临床表现为经典的感觉运动型，共74例（91.36%），其中急性炎症性脱髓鞘性多发性神经病（AIDP，82.35%）是COVID-19组最常见的神经生理学类型，而急性运动轴索性神经病（AMAN）类型在无COVID-19的患者中占主导（59.26%）（P<0.000）。在调整年龄、性别和神经生理学亚型后，COVID-19患者与无COVID-19患者出院时的残疾患病率比值为1.89（95%置信区间1.06 - 3.34），P = 0.030。
结论
神经生理学亚型AIDP以及更高的残疾率与COVID-19的存在相关。
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