Impact of COVID-19 on Guillain-Barre Syndrome in India: A Multicenter Ambispective Cohort Study.
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Sireesha Yareeda, Shree Ritu, Nagappa Madhu, Patil Anuja, Singla Monika, Padma Srivastava M V, Dhamija R K, Balaram Neetha, Pathak Abhishek, Ramachandran Dileep, Kumar Sujit, Puri Inder, Sharma Sudhir, Panda Samhita, Desai Soaham, Samal Priyanka, Choudhary Aditya, Vijaya Pamidimukkala, Ferreira Teresa, Nair S S, Sinha H P, Bhoi S K, Sebastian Joseph, Sharma Sanjay, Basheer Aneesh, Bhartiya Manish, Mathukumalli N L, Jabeen Shaikh Afshan, Lal Vivek, Modi Manish, Sharma P Praveen, Kaul Subash, Singh Gagandeep, Agarwal Ayush, Garg Divyani, Jose James, Dev Priya, Iype Thomas, Gopalakrishnan Maya, Upadhyay Ashish, Bhatia Rohit, Pandit Awadh K, Singh Rajesh K, Salunkhe Manish, Yogeesh P M, Reyaz Alisha, Nadda Nishant, Jha Menkha, Kumar Bismay, Kushwaha P K, Chovatiya Harshadkumar, Madduluri Bhavani, Ramesh P, Goel Abeer, Yadav Rahul, Vishnu Venugopalan Y, GBS consortium
Аннотация
METHODS: A multicenter, ambispective cohort study including 26 centers across India was conducted. Data from a pre-COVID-19 period (March 1 to August 31, 2019) were collected retrospectively and collected ambispectively for a specified COVID-19 period (March 1 to August 31, 2020). The study was registered with the Clinical Trial Registry India (CTRI/2020/11/029143).
RESULTS: Data from 555 patients were included for analysis: pre-COVID-19 (n = 334) and COVID-19 (n = 221). Males were more commonly affected during both periods (male:female, 2:1). Gastroenteritis was the most frequent antecedent event in 2019 (17.4%), whereas fever was the most common event in 2020 (10.7%). Paraparesis (21.3% versus [vs.] 9.3%, P = 0.001) and sensory involvement (51.1% vs. 41.3%; P = 0.023) were more common during COVID-19 in 2020, whereas back pain (26.3% vs. 18.4%; P = 0.032) and bowel symptoms (20.7% vs. 13.7%; P = 0.024) were more frequent in the pre-COVID period. There was no difference in clinical outcomes between the two groups in terms of GBS disability score at discharge and 3 months after discharge. Independent predictors of disability in the pre-COVID period included areflexia/hyporeflexia, the requirementfor intubation, and time to bulbar weakness; in the COVID-19 period, independent predictors included time from onset to admission, intubation, and intubation requirement. The mortality rate was 2.3% during the entire study period (13/555 cases).
DISCUSSION: Results of this study revealed an overall reduction in the frequency of GBS during the pandemic. The lockdown likely reduced the risk for antecedent infections due to social distancing and improved hygiene, which may have resulted in the reduction of the frequency of GBS.