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克罗地亚斯普利特大学医院为期一年的新冠后吉兰-巴雷综合征分析。

Analysis of Post-COVID-19 Guillain-Barré Syndrome over a Period of One Year in the University Hospital of Split (Croatia).

作者信息

Dunkić Niko, Nazlić Marija, Dunkić Valerija, Bilić Ivica

机构信息

Practice of General Medicine, A.G. Matoša 2, 21000 Split, Croatia.

Faculty of Science, University of Split, Ruđera Boškovića 33, 21000 Split, Croatia.

出版信息

Neurol Int. 2023 Nov 6;15(4):1359-1370. doi: 10.3390/neurolint15040086.

Abstract

The virus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) is capable of attacking the nervous system in several ways and leading to neurological diseases such as GBS (Guillain-Barré syndrome) through the resulting neurotropism and immune response. The aim of this study is to show the relationship between Coronavirus disease (COVID-19) and GBS and to better understand the clinical symptoms to prevent poor outcomes. Data from 15 patients were extracted from the Department of Neurology, University Hospital of Split, Croatia, for the year 2021. The age of the patients ranged from 26 to 89 years, of whom 27% were women. Sixty seven percent of all GBS patients recovered from COVID-19 infection, whereas post-vaccinal polyradiculoneuritis was detected in 6%. Forty four percent of the patients who developed GBS had a severe form of COVID-19 infection. Forty percent of patients were treated with intravenous immunoglobulins (IVIG), followed by therapeutic plasma exchange (PLEX) in 27%. After the therapy, improvement was observed in 13 patients, while two patients died. The results suggest that SARS-CoV-2 triggers GBS because it follows a similar pattern of infection as the other viral and bacterial agents that contribute to the onset of GBS. There is no evidence that prior infection with COVID-19 worsens the clinical presentation of GBS.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)能够通过产生的嗜神经性和免疫反应,以多种方式攻击神经系统,并导致格林-巴利综合征(GBS)等神经系统疾病。本研究的目的是揭示冠状病毒病(COVID-19)与GBS之间的关系,并更好地了解临床症状以预防不良后果。从克罗地亚斯普利特大学医院神经科提取了2021年15例患者的数据。患者年龄在26至89岁之间,其中27%为女性。所有GBS患者中有67%从COVID-19感染中康复,而6%检测到接种疫苗后发生多神经根神经炎。发生GBS的患者中有44%患有严重的COVID-19感染。40%的患者接受了静脉注射免疫球蛋白(IVIG)治疗,随后27%的患者接受了治疗性血浆置换(PLEX)。治疗后,13例患者病情改善,2例患者死亡。结果表明,SARS-CoV-2引发GBS,因为它遵循与其他导致GBS发病的病毒和细菌病原体相似的感染模式。没有证据表明先前的COVID-19感染会使GBS的临床表现恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbf8/10661271/9d369fb0b248/neurolint-15-00086-g001.jpg

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