Association of Guillain-Barre syndrome with COVID-19 infection: An updated systematic review

Objective The systematic review aimed to determine demographic characteristics, clinical features, lab evaluation, management and complications of the studies focusing on Guillain-Barre syndrome (GBS) as a sequele of novel coronavirus (COVID-19) infection Methods After protocol registration, PubMed, Web of Science and Cumulative Index to Nursing & Allied Health Literature (CINHAL) databases were searched for relevant articles using MeSH key-words and imported into referencing/review softwares The data, regarding demographic and clinical characteristics, diagnostic workup and management, was analyzed in International Business Machines (IBM) Statistics SPSS 21 Many statistical tests, such as t-test and the Mann–Whitney U test, were used P < 0 05 was considered significant Results We identified 64 relevant articles The mean age of the patients was 56 ± 16 years;the majority were males (64 9%) Among the neurological findings, paresthesia was the most typical symptom (48 9%) Most of the patients had been diagnosed by reverse transcriptase-polymerase chain reaction (RT-PCR) (69 2%) Two-third of the patients received immunoglobulins (IVIg) (77 7%) Although functions recovered in most patients, there were four patients with facial diplegia during follow-up (4 26%) Acute inflammatory demyelinating polyneuropathy (AIDP) was more likely to be associated with paresis of the lower extremity (p < 0 05) and higher levels of glucose on cerebrospinal fluid (CSF) analysis (p < 0 05) These patients were more likely to receive IVIg (p < 0 05) and develop respiratory insufficiency, subsequently (p < 0 05) Conclusions GBS is being recognized as one of the many presentations of the COVID-19 infection Although the common form is AIDP that might lead to complications, other variants are possible as well, and more studies are needed to focus on those subvariants