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Annals of Indian Academy of Neurology
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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


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
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aian.AIAN_1303_20

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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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