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?:abstract
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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
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