Guillian--Barre' syndrome in patients with SARS-CoV-2: A multicentric study from Maharashtra, India

Megha C Dhamne; Rajesh Benny; Rakesh Singh; Amitkumar Pande; Pankaj Agarwal; Satish Wagh; Pradyumna Oak; Akshay Lakhotia; Yogesh Godge; Vyankatesh Bolegave; Darshan Doshi; Yogesh Patidar; Anil Venkatachalam; Bhavin Pujara; Sandeep Borse; Prashant Makhija; Satish Khadilkar

doi:10.4103/aian.AIAN_1303_20


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ORIGINAL ARTICLE

Year : 2021 | Volume : 24 | Issue : 3 | Page : 339-346

Guillian--Barre' syndrome in patients with SARS-CoV-2: A multicentric study from Maharashtra, India

Megha C Dhamne¹, Rajesh Benny², Rakesh Singh², Amitkumar Pande³, Pankaj Agarwal⁴, Satish Wagh⁵, Pradyumna Oak⁶, Akshay Lakhotia⁷, Yogesh Godge⁸, Vyankatesh Bolegave⁹, Darshan Doshi¹⁰, Yogesh Patidar¹¹, Anil Venkatachalam¹², Bhavin Pujara¹³, Sandeep Borse¹⁴, Prashant Makhija¹⁵, Satish Khadilkar¹⁶
¹ Dr. L H Hiranandani Hospital, Powai, Mumbai, Maharashtra, India
² Fortis Hospital, Mulund, Mumbai, Maharashtra, India
³ Vedant Multispeciality Hospital, Chinchwad, Pune, Maharashtra, India
⁴ Global Hospitals, Mumbai, Maharashtra, India
⁵ Reliance Hospital, Navi Mumbai, Maharashtra, India
⁶ Nanavati Super Speciality Hospital, Mumbai, Maharashtra, India
⁷ Navkiran Neurohospital, Akola, Maharashtra, India
⁸ Jupiter Hospital, Thane West, Maharashtra, India
⁹ Highland Superspeciality Hospital, Thane, Maharashtra, India
¹⁰ Holy Spirit Hospital, Andheri East, Maharashtra, India
¹¹ Bhaktivedanta Hospital and Resarch Center, Thane, Maharashtra, India
¹² Somaiya Superspecialty Hospital, Mumbai, Maharashtra, India
¹³ Aditi Hospital, Mulund, Mumbai, Maharashtra, India
¹⁴ Jehangir Hospital, Pune, Maharashtra, India
¹⁵ Wockhardt Hospital, Mumbai, Maharashtra, India
¹⁶ Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Megha C Dhamne
Department of Neurology, Dr. L H Hiranandani Hospital, Hillside Road, Hiranandani Gardens, Powai, Mumbai - 400 076
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/aian.AIAN_1303_20

Background: Guillian--Barre' Syndrome (GBS) has been shown to be associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The aim of our study was to study the clinical profile and outcomes of GBS in COVID-19 from the Western region of India, the State of Maharashtra. Methods: This was a retrospective, multicenter observation study from different hospitals in Maharashtra beginning from March 2020 until November 2020. Results: We report 42 patients with COVID-19 GBS. Mean age was 59 years (range, 24--85 years). 31/42 (73.8%) were men. GBS was the presenting symptom in 14/42 (33%), while six of them remained asymptomatic for COVID-19 despite positive SARS-CoV-2 on nasopharyngeal swab reverse transcriptase polymerase chain reaction. The median interval between COVID-19 and GBS was 14 days (SD + 11), with minimum of 1 and maximum 40 days. Clinical presentation was like that of typical GBS. Electrophysiological studies showed a predominant demyelinating pattern in 25/42 (59.5%). Inflammatory markers were elevated in 35/42 (83.3%) and 38/42 (90.5%) had an Abnormal high-resolution CT (HRCT) chest. 14/42 (33.3%) patients required a ventilator, with nine deaths. Intravenous immunoglobulin was the mainstay of treatment for GBS. Majority had a good outcome and were walking independently or with minimal support at discharge. In subgroup analysis, the postinfectious group had a better outcome than the parainfectious group. Conclusion: GBS in COVID-19 occurs as both parainfectious and postinfectious GBS. Parainfectious GBS needs more rigorous monitoring and may benefit from COVID-19 specific treatment. Routine screening for SARS-CoV-2 should be implemented in patients with GBS in view of the ongoing pandemic.

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