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格林-巴利综合征与 COVID-19 疫苗:46 例病例的多中心回顾性研究。

Guillain-Barré Syndrome and COVID-19 Vaccine: A Multicenter Retrospective Study of 46 Cases.

机构信息

From the Department of Neurology, FLENI, Buenos Aires, Argentina.

Department of Neurology, Sanatorio Finochietto, Buenos Aires, Argentina.

出版信息

J Clin Neuromuscul Dis. 2023 Sep 1;25(1):1-10. doi: 10.1097/CND.0000000000000437.

Abstract

In the context of the global vaccination campaign against COVID-19, several cases of postvaccinal Guillain-Barré syndrome (GBS) were reported. Whether a causal relationship exists between these events has yet to be established. We investigated the clinical and electromyographic characteristics of patients who developed GBS after COVID-19 vaccination and compare these with findings in patients with GBS, without a history of recent vaccination. We included 91 cases between March 2020 and March 2022, treated at 10 referral hospitals of Buenos Aires, Argentina. Of these, 46 had received vaccination against COVID-19 within the previous month. Although Medical Research Council sum-scores were similar in both groups (median 52 vs. 50; P = 0.4), cranial nerve involvement was significantly more frequent in the postvaccination group (59% vs. 38%; P = 0.02), as was bilateral facial paralysis (57% vs. 24%; P = 0.002). No differences were found in clinical or neurophysiological phenotypes, although 17 subjects presented the variant of bilateral facial palsy with paresthesias (11 vs. 6; P = 0.1); nor were significant differences observed in length of hospital stay or mortality rates. Future vaccine safety monitoring and epidemiology studies are essential to demonstrate any potential causal relationship between these events.

摘要

在全球针对 COVID-19 的疫苗接种活动中,报道了几例疫苗接种后吉兰-巴雷综合征(GBS)病例。这些事件之间是否存在因果关系尚未确定。我们调查了 COVID-19 疫苗接种后发生 GBS 的患者的临床和肌电图特征,并将这些特征与近期无疫苗接种史的 GBS 患者的发现进行了比较。我们纳入了 2020 年 3 月至 2022 年 3 月期间在阿根廷布宜诺斯艾利斯的 10 家转诊医院治疗的 91 例患者。其中,46 例在过去一个月内接种了 COVID-19 疫苗。尽管两组的英国医学研究理事会总和评分相似(中位数 52 对 50;P = 0.4),但接种后组的颅神经受累明显更常见(59%对 38%;P = 0.02),双侧面瘫也更常见(57%对 24%;P = 0.002)。在临床或神经生理表型方面没有发现差异,尽管 17 例患者表现为双侧面瘫伴感觉异常(11 例对 6 例;P = 0.1);住院时间或死亡率也没有显著差异。未来的疫苗安全性监测和流行病学研究对于证明这些事件之间存在任何潜在的因果关系至关重要。

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