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Guillain-Barré syndrome and COVID-19: an observational multicentre study from two Italian hotspot regions.
Filosto, Massimiliano; Cotti Piccinelli, Stefano; Gazzina, Stefano; Foresti, Camillo; Frigeni, Barbara; Servalli, Maria Cristina; Sessa, Maria; Cosentino, Giuseppe; Marchioni, Enrico; Ravaglia, Sabrina; Briani, Chiara; Castellani, Francesca; Zara, Gabriella; Bianchi, Francesca; Del Carro, Ubaldo; Fazio, Raffaella; Filippi, Massimo; Magni, Eugenio; Natalini, Giuseppe; Palmerini, Francesco; Perotti, Anna Maria; Bellomo, Andrea; Osio, Maurizio; Scopelliti, Giuseppe; Carpo, Marinella; Rasera, Andrea; Squintani, Giovanna; Doneddu, Pietro Emiliano; Bertasi, Valeria; Cotelli, Maria Sofia; Bertolasi, Laura; Fabrizi, Gian Maria; Ferrari, Sergio; Ranieri, Federico; Caprioli, Francesca; Grappa, Elena; Broglio, Laura; De Maria, Giovanni; Leggio, Ugo; Poli, Loris; Rasulo, Frank; Latronico, Nicola; Nobile-Orazio, Eduardo; Padovani, Alessandro; Uncini, Antonino.
  • Filosto M; Department of Clinical and Experimental Sciences, University of Brescia; Unit of Neurology, ASST Spedali Civili; NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy massimiliano.filosto@unibs.it.
  • Cotti Piccinelli S; Department of Clinical and Experimental Sciences, University of Brescia; Unit of Neurology, ASST Spedali Civili, Brescia, Italy.
  • Gazzina S; Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy.
  • Foresti C; Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy.
  • Frigeni B; Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy.
  • Servalli MC; Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy.
  • Sessa M; Unit of Neurology and Neurophysiology, ASST PG23, Bergamo, Italy.
  • Cosentino G; IRCCS Mondino Foundation, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
  • Marchioni E; IRCCS Mondino Foundation, Neurooncology and Neuroinflammation Unit, Pavia, Italy.
  • Ravaglia S; IRCCS Mondino Foundation, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
  • Briani C; Neurology Unit, Azienda Ospedale-Università di Padova, Padova, Italy.
  • Castellani F; Neurology Unit, Azienda Ospedale-Università di Padova, Padova, Italy.
  • Zara G; Neurology Unit, Azienda Ospedale-Università di Padova, Padova, Italy.
  • Bianchi F; Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute SanRaffaele University, Milano, Italy.
  • Del Carro U; Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute SanRaffaele University, Milano, Italy.
  • Fazio R; Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute SanRaffaele University, Milano, Italy.
  • Filippi M; Neurology and Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Vita Salute SanRaffaele University, Milano, Italy.
  • Magni E; Unit of Neurology, Fondazione Poliambulanza, Brescia, Italy.
  • Natalini G; Unit of Intensive Care and Anesthesiology, Fondazione Poliambulanza, Brescia, Italy.
  • Palmerini F; Unit of Neurology, Fondazione Poliambulanza, Brescia, Italy.
  • Perotti AM; Unit of Neurology, Fondazione Poliambulanza, Brescia, Italy.
  • Bellomo A; ''Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milano, Milano, Italy.
  • Osio M; Unit of Neurology, ASST Fatebenefratelli Sacco, Milano, Italy.
  • Scopelliti G; ''Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milano, Milano, Italy.
  • Carpo M; Unit of Neurology, ASST Bergamo Ovest, Treviglio, Italy.
  • Rasera A; Unit of Neurology, AOUI Verona, Verona, Italy.
  • Squintani G; Unit of Neurology, AOUI Verona, Verona, Italy.
  • Doneddu PE; Department of Neurology, Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute; Department of Medical Biotechnology and Translational Medicine,Milan University, Milano, Italy.
  • Bertasi V; Unit of Neurology, ASST Valcamonica, Esine (Bs), Italy.
  • Cotelli MS; Unit of Neurology, ASST Valcamonica, Esine (Bs), Italy.
  • Bertolasi L; Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
  • Fabrizi GM; Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
  • Ferrari S; Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
  • Ranieri F; Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
  • Caprioli F; Unit of Neurology, ASST Cremona, Cremona, Italy.
  • Grappa E; Intensive Care Unit, ASST Cremona, Cremona, Italy.
  • Broglio L; Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy.
  • De Maria G; Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy.
  • Leggio U; Unit of Neurophysiopathology, ASST Spedali Civili, Brescia, Italy.
  • Poli L; Unit of Neurology, ASST Spedali Civili, Brescia, Italy.
  • Rasulo F; Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili;Department of Medical and Surgical Specialties, Radiological Sciences and Public Health,University of Brescia, Brescia, Italy.
  • Latronico N; Department of Anesthesia, Critical Care and Emergency, ASST Spedali Civili;Department of Medical and Surgical Specialties, Radiological Sciences and Public Health,University of Brescia, Brescia, Italy.
  • Nobile-Orazio E; Department of Neurology, Neuromuscular and Neuroimmunology Service, IRCCS Humanitas Clinical and Research Institute; Department of Medical Biotechnology and Translational Medicine,Milan University, Milano, Italy.
  • Padovani A; Department of Clinical and Experimental Sciences, University of Brescia; Unit of Neurology, ASST Spedali Civili, Brescia, Italy.
  • Uncini A; Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio", Chieti-Pescara, Italy.
J Neurol Neurosurg Psychiatry ; 92(7): 751-756, 2021 07.
Article in English | MEDLINE | ID: covidwho-1269801
ABSTRACT

OBJECTIVE:

Single cases and small series of Guillain-Barré syndrome (GBS) have been reported during the SARS-CoV-2 outbreak worldwide. We evaluated incidence and clinical features of GBS in a cohort of patients from two regions of northern Italy with the highest number of patients with COVID-19.

METHODS:

GBS cases diagnosed in 12 referral hospitals from Lombardy and Veneto in March and April 2020 were retrospectively collected. As a control population, GBS diagnosed in March and April 2019 in the same hospitals were considered.

RESULTS:

Incidence of GBS in March and April 2020 was 0.202/100 000/month (estimated rate 2.43/100 000/year) vs 0.077/100 000/month (estimated rate 0.93/100 000/year) in the same months of 2019 with a 2.6-fold increase. Estimated incidence of GBS in COVID-19-positive patients was 47.9/100 000 and in the COVID-19-positive hospitalised patients was 236/100 000. COVID-19-positive patients with GBS, when compared with COVID-19-negative subjects, showed lower MRC sum score (26.3±18.3 vs 41.4±14.8, p=0.006), higher frequency of demyelinating subtype (76.6% vs 35.3%, p=0.011), more frequent low blood pressure (50% vs 11.8%, p=0.017) and higher rate of admission to intensive care unit (66.6% vs 17.6%, p=0.002).

CONCLUSIONS:

This study shows an increased incidence of GBS during the COVID-19 outbreak in northern Italy, supporting a pathogenic link. COVID-19-associated GBS is predominantly demyelinating and seems to be more severe than non-COVID-19 GBS, although it is likely that in some patients the systemic impairment due to COVID-19 might have contributed to the severity of the whole clinical picture.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Guillain-Barre Syndrome / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: J Neurol Neurosurg Psychiatry Year: 2021 Document Type: Article Affiliation country: Jnnp-2020-324837

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Guillain-Barre Syndrome / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: J Neurol Neurosurg Psychiatry Year: 2021 Document Type: Article Affiliation country: Jnnp-2020-324837