Guillain-Barré syndrome in SARS-CoV-2 infection: an instant systematic review of the first six months of pandemic.
Identifieur interne : 000548 ( Main/Exploration ); précédent : 000547; suivant : 000549Guillain-Barré syndrome in SARS-CoV-2 infection: an instant systematic review of the first six months of pandemic.
Auteurs : Antonino Uncini [Italie] ; Jean-Michel Vallat [France] ; Bart C. Jacobs [Pays-Bas]Source :
- Journal of neurology, neurosurgery, and psychiatry [ 1468-330X ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Betacoronavirus (MeSH), Femelle (MeSH), Humains (MeSH), Infections à coronavirus (complications), Infections à coronavirus (diagnostic), Infections à coronavirus (thérapie), Jeune adulte (MeSH), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (complications), Pneumopathie virale (diagnostic), Pneumopathie virale (thérapie), Sujet âgé (MeSH), Syndrome de Guillain-Barré (diagnostic), Syndrome de Guillain-Barré (thérapie), Syndrome de Guillain-Barré (virologie).
- MESH :
- diagnostic : Infections à coronavirus, Pneumopathie virale, Syndrome de Guillain-Barré.
- thérapie : Infections à coronavirus, Pneumopathie virale, Syndrome de Guillain-Barré.
- virologie : Syndrome de Guillain-Barré.
- complications : Adulte, Adulte d'âge moyen, Betacoronavirus, Femelle, Humains, Infections à coronavirus, Jeune adulte, Mâle, Pandémies, Pneumopathie virale, Sujet âgé.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Betacoronavirus (MeSH), Coronavirus Infections (complications), Coronavirus Infections (diagnosis), Coronavirus Infections (therapy), Female (MeSH), Guillain-Barre Syndrome (diagnosis), Guillain-Barre Syndrome (therapy), Guillain-Barre Syndrome (virology), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (diagnosis), Pneumonia, Viral (therapy), Young Adult (MeSH).
- MESH :
- complications : Coronavirus Infections, Pneumonia, Viral.
- diagnosis : Coronavirus Infections, Guillain-Barre Syndrome, Pneumonia, Viral.
- therapy : Coronavirus Infections, Guillain-Barre Syndrome, Pneumonia, Viral.
- virology : Guillain-Barre Syndrome.
- Adult, Aged, Betacoronavirus, Female, Humans, Male, Middle Aged, Pandemics, Young Adult.
Abstract
A systematic review from 1 January to 30 June 2020 revealed 42 patients with Guillain-Barré syndrome (GBS) associated with SARS-CoV-2 infection. Single cases and small series were reported from 13 countries, the majority from Europe (79.4%) and especially from Italy (30.9%). SARS-CoV-2 infection was demonstrated by nasopharyngeal swab (85.7%) and serology (14.3%). Median time between COVID-19 and GBS onset in 36 patients was 11.5 days (IQR: 7.7-16). The most common clinical features were: limb weakness (76.2%), hypoareflexia (80.9 %), sensory disturbances (66.7 %) and facial palsy (38.1%). Dysautonomia occurred in 19%, respiratory failure in 33.3% and 40.5% of patients were admitted in intensive care unit. Most patients (71.4%) had the classical clinical presentation but virtually all GBS variants and subtypes were reported. Cerebrospinal fluid (CSF) albumin-cytological dissociation was found in 28/36 (77.8%) and PCR for SARS-CoV-2 was negative in 25/25 patients. Electrodiagnosis was demyelinating in 80.5% and levels 1 and 2 of Brighton criteria of diagnostic certainty, when applicable, were fulfilled in 94.5% patients. Antiganglioside antibodies were positive in only 1/22 patients. Treatments were intravenous immunoglobulin and/or plasma exchange (92.8%) with, at short-time follow-up, definite improvement or recovery in 62.1% of patients. One patient died. In conclusion, the most frequent phenotype of GBS in SARS-CoV-2 infection is the classical sensorimotor demyelinating GBS responding to the usual treatments. The time interval between infectious and neuropathic symptoms, absence of CSF pleocytosis and negative PCR support a postinfectious mechanism. The abundance of reports suggests a pathogenic link between SARS-CoV-2 infection and GBS but a case-control study is greatly needed.
DOI: 10.1136/jnnp-2020-324491
PubMed: 32855289
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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<term>Coronavirus Infections (complications)</term>
<term>Coronavirus Infections (diagnosis)</term>
<term>Coronavirus Infections (therapy)</term>
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<term>Guillain-Barre Syndrome (therapy)</term>
<term>Guillain-Barre Syndrome (virology)</term>
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<term>Pneumonia, Viral (diagnosis)</term>
<term>Pneumonia, Viral (therapy)</term>
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<term>Adulte d'âge moyen (MeSH)</term>
<term>Betacoronavirus (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Infections à coronavirus (complications)</term>
<term>Infections à coronavirus (diagnostic)</term>
<term>Infections à coronavirus (thérapie)</term>
<term>Jeune adulte (MeSH)</term>
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<term>Pneumopathie virale (diagnostic)</term>
<term>Pneumopathie virale (thérapie)</term>
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<term>Syndrome de Guillain-Barré (thérapie)</term>
<term>Syndrome de Guillain-Barré (virologie)</term>
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<term>Pneumonia, Viral</term>
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<term>Guillain-Barre Syndrome</term>
<term>Pneumonia, Viral</term>
</keywords>
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<term>Pneumopathie virale</term>
<term>Syndrome de Guillain-Barré</term>
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<term>Guillain-Barre Syndrome</term>
<term>Pneumonia, Viral</term>
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<keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Infections à coronavirus</term>
<term>Pneumopathie virale</term>
<term>Syndrome de Guillain-Barré</term>
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<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Syndrome de Guillain-Barré</term>
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<term>Aged</term>
<term>Betacoronavirus</term>
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<term>Humans</term>
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<front><div type="abstract" xml:lang="en">A systematic review from 1 January to 30 June 2020 revealed 42 patients with Guillain-Barré syndrome (GBS) associated with SARS-CoV-2 infection. Single cases and small series were reported from 13 countries, the majority from Europe (79.4%) and especially from Italy (30.9%). SARS-CoV-2 infection was demonstrated by nasopharyngeal swab (85.7%) and serology (14.3%). Median time between COVID-19 and GBS onset in 36 patients was 11.5 days (IQR: 7.7-16). The most common clinical features were: limb weakness (76.2%), hypoareflexia (80.9 %), sensory disturbances (66.7 %) and facial palsy (38.1%). Dysautonomia occurred in 19%, respiratory failure in 33.3% and 40.5% of patients were admitted in intensive care unit. Most patients (71.4%) had the classical clinical presentation but virtually all GBS variants and subtypes were reported. Cerebrospinal fluid (CSF) albumin-cytological dissociation was found in 28/36 (77.8%) and PCR for SARS-CoV-2 was negative in 25/25 patients. Electrodiagnosis was demyelinating in 80.5% and levels 1 and 2 of Brighton criteria of diagnostic certainty, when applicable, were fulfilled in 94.5% patients. Antiganglioside antibodies were positive in only 1/22 patients. Treatments were intravenous immunoglobulin and/or plasma exchange (92.8%) with, at short-time follow-up, definite improvement or recovery in 62.1% of patients. One patient died. In conclusion, the most frequent phenotype of GBS in SARS-CoV-2 infection is the classical sensorimotor demyelinating GBS responding to the usual treatments. The time interval between infectious and neuropathic symptoms, absence of CSF pleocytosis and negative PCR support a postinfectious mechanism. The abundance of reports suggests a pathogenic link between SARS-CoV-2 infection and GBS but a case-control study is greatly needed.</div>
</front>
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<Abstract><AbstractText>A systematic review from 1 January to 30 June 2020 revealed 42 patients with Guillain-Barré syndrome (GBS) associated with SARS-CoV-2 infection. Single cases and small series were reported from 13 countries, the majority from Europe (79.4%) and especially from Italy (30.9%). SARS-CoV-2 infection was demonstrated by nasopharyngeal swab (85.7%) and serology (14.3%). Median time between COVID-19 and GBS onset in 36 patients was 11.5 days (IQR: 7.7-16). The most common clinical features were: limb weakness (76.2%), hypoareflexia (80.9 %), sensory disturbances (66.7 %) and facial palsy (38.1%). Dysautonomia occurred in 19%, respiratory failure in 33.3% and 40.5% of patients were admitted in intensive care unit. Most patients (71.4%) had the classical clinical presentation but virtually all GBS variants and subtypes were reported. Cerebrospinal fluid (CSF) albumin-cytological dissociation was found in 28/36 (77.8%) and PCR for SARS-CoV-2 was negative in 25/25 patients. Electrodiagnosis was demyelinating in 80.5% and levels 1 and 2 of Brighton criteria of diagnostic certainty, when applicable, were fulfilled in 94.5% patients. Antiganglioside antibodies were positive in only 1/22 patients. Treatments were intravenous immunoglobulin and/or plasma exchange (92.8%) with, at short-time follow-up, definite improvement or recovery in 62.1% of patients. One patient died. In conclusion, the most frequent phenotype of GBS in SARS-CoV-2 infection is the classical sensorimotor demyelinating GBS responding to the usual treatments. The time interval between infectious and neuropathic symptoms, absence of CSF pleocytosis and negative PCR support a postinfectious mechanism. The abundance of reports suggests a pathogenic link between SARS-CoV-2 infection and GBS but a case-control study is greatly needed.</AbstractText>
<CopyrightInformation>© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Uncini</LastName>
<ForeName>Antonino</ForeName>
<Initials>A</Initials>
<Identifier Source="ORCID">0000-0002-8131-8912</Identifier>
<AffiliationInfo><Affiliation>Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy uncini@unich.it.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Vallat</LastName>
<ForeName>Jean-Michel</ForeName>
<Initials>JM</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, National Reference Center for "Rare Peripheral Neuropathies", CHU Dupuytren, Limoges, France.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Jacobs</LastName>
<ForeName>Bart C</ForeName>
<Initials>BC</Initials>
<AffiliationInfo><Affiliation>Departments of Neurology and Immunology, Erasmus MC, Rotterdam, The Netherlands.</Affiliation>
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<CoiStatement>Competing interests: None declared.</CoiStatement>
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<country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Jacobs, Bart C" sort="Jacobs, Bart C" uniqKey="Jacobs B" first="Bart C" last="Jacobs">Bart C. Jacobs</name>
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