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新型冠状病毒肺炎疫苗接种后吉兰-巴雷综合征:关于其临床、实验室、电生理及影像学特征的系统评价与数据分析

Guillain-Barré syndrome post-SARS-CoV-2 vaccine: a systematic review and data analysis on its clinical, laboratory, electrophysiological, and radiological features.

作者信息

Hadhiah Kawther, Alhashim Ali, Al-Dandan Hassan A, Alhassan Eman, Alqarni Abdulaziz M, Memish Abdullah Adil A, Alabdali Majed

机构信息

Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

出版信息

Front Neurol. 2024 Jan 29;15:1332364. doi: 10.3389/fneur.2024.1332364. eCollection 2024.

Abstract

INTRODUCTION

Guillain-Barré syndrome (GBS) is a rare disease that affects almost 0.8-1.9 cases per 100,000 people worldwide every year. This is the most prevalent cause of subacute flaccid paralyzing illness today. It is a subacute inflammatory demyelinating polyradiculoneuropathy; the typical scenario involves ascending symmetrical flaccid paralysis, but in some circumstances, sensory, autonomic, and cranial neuropathy may also be involved. Several vaccines have been found to have complications since the previous century. Numerous case reports of GBS in the literature have been reported following COVID-19 vaccines in recent times.

OBJECTIVE

This study aimed to conduct a comprehensive examination of GBS cases that have been reported after COVID-19 vaccines; to analyze the descriptive statistical analysis of data gathered regarding clinical, laboratory, electrophysiological, and radiological characteristics; to discuss, based on the available evidence, whether the disease has a preference for a particular vaccine type; and to speculate on the potential pathogenesis.

METHODOLOGY

This review has been carried out by recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULT

Reviewing 60 case reports illustrated that most of them are from the USA (18.1%) and the majority of affected individuals were males (60%). The results favored the association between vector-based SARS-CoV-2 vaccine, particularly AstraZeneca vaccine, and the GBS. The mean of symptoms onset is 11.4 days. The results of diagnostic tests such as LP are consistent mostly with albumin-cytological dissociation (81.81%), where brain and spine MRI was unremarkable in 59.52%. Regarding electrodiagnostic tests, AIDP is the most common variant (61.81%). The management was not consistent among the case reports. However, IVIG is the most frequent way of treating these patients (68.33%). The functional outcome was documented in 47 patients; 65% improved with medical management.

CONCLUSION

This study aimed to conduct a systematic review of reported cases of GBS following COVID-19 vaccines and descriptive statistical analysis of collected data on clinical, laboratory, electrophysiological, and radiological features, to discuss, based on available results, whether the disease has a predilection to a specific vaccine type and to speculate the potential pathogenesis.

摘要

引言

吉兰-巴雷综合征(GBS)是一种罕见疾病,全球每年每10万人中约有0.8 - 1.9例发病。它是当今亚急性弛缓性麻痹疾病最常见的病因。这是一种亚急性炎症性脱髓鞘性多发性神经根神经病;典型情况是对称性上行性弛缓性麻痹,但在某些情况下,也可能涉及感觉、自主神经和颅神经病变。自上世纪以来,已发现几种疫苗存在并发症。近年来,文献中有大量关于接种新冠疫苗后发生GBS的病例报告。

目的

本研究旨在全面检查新冠疫苗接种后报告的GBS病例;分析收集到的有关临床、实验室、电生理和放射学特征的数据的描述性统计分析;根据现有证据讨论该疾病是否对特定疫苗类型有偏好;并推测潜在的发病机制。

方法

本综述按照系统评价和Meta分析的首选报告项目(PRISMA)指南的建议进行。

结果

回顾60例病例报告表明,其中大多数来自美国(18.1%),大多数受影响个体为男性(60%)。结果支持基于载体的SARS-CoV-2疫苗,特别是阿斯利康疫苗与GBS之间的关联。症状出现的平均时间为11.4天。腰椎穿刺等诊断测试结果大多与蛋白细胞分离一致(81.81%),其中59.52%的脑和脊柱MRI无明显异常。关于电诊断测试,急性炎症性脱髓鞘性多发性神经病(AIDP)是最常见的类型(61.81%)。病例报告中的治疗方法不一致。然而,静脉注射免疫球蛋白(IVIG)是治疗这些患者最常用的方法(68.33%)。记录了47例患者的功能结局;65%的患者经药物治疗后有所改善。

结论

本研究旨在对新冠疫苗接种后报告的GBS病例进行系统综述,并对收集到的有关临床、实验室、电生理和放射学特征的数据进行描述性统计分析,根据现有结果讨论该疾病是否对特定疫苗类型有偏好,并推测潜在的发病机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5aa4/10863047/284ea985dc25/fneur-15-1332364-g001.jpg

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