Guillain-Barré Syndrome During the COVID-19 Pandemic

ABSTRACT

Objective: We are investigating whether COVID-19 infection increases the propensity of developing Guillain-Barré Syndrome (GBS) or affects the clinical outcome of GBS. Background: During the pandemic, there have been many case reports and case series of GBS following COVID-19 infection. The causality of COVID-19 in these cases is not clear. There are conflicting reports regarding the incidence of GBS during the pandemic. In prior literature, clinical and electrophysiologic characteristics of GBS in COVID-19 associated cases did not differ from the previously described natural history. Design/Methods: Longitudinal electronic health record database for Optum, which included more than 4.4 million patients who underwent testing for COVID-19, was queried in May 2021 for ICD-9 and ICD-10 codes for GBS. Clinical information based on billing codes was acquired. GBS cases within 60 days of the first positive PCR test for COVID-19 were further analyzed. We also evaluated the presence of GBS in patients who tested negative for COVID 19 during the same time frame. Results: There were 725,347 patients in the database with COVID-19 diagnosis. We analyzed 844 patients with GBS, 86 of which occurred within 60 days of COVID-19 diagnosis. The incidence of GBS was not increased among the patients with recent COVID 19 diagnosis, compared to the GBS cases without COVID 19 in the same time frame. In our preliminary analysis, COVID-19 associated cases had higher mortality, intubation rates, and need for posthospital rehabilitation at a facility. Conclusions: Our preliminary analysis of this large database did not show any evidence that COVID-19 increases the propensity for developing GBS. However, when associated with COVID-19 infection, the outcomes for GBS seem to be worse. Further ongoing analyses considering covariates of age, comorbidities, and month of COVID-19 diagnosis is planned.