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?:abstract
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Background: Guillain-Barre Syndrome (GBS) is a neurological autoimmune disease that can lead to respiratory failure and death Whether COVID-19 patients are at high risk of GBS is unknown Through a systematic review of case reports, we aimed to summarize the main features of patients with GBS and COVID-19 Methods: Without any restrictions, we searched MEDLINE, Embase, Global Health, Scopus, Weof Science and MedXriv (April 23rd, 2020) Two reviewers screened and studied titles, abstracts and reports We extracted information to characterize sociodemographic variables, clinical presentation, laboratory results, treatments and outcomes Results: Eight reports (n=12 patients) of GBS and COVID-19 were identified;one was a Miller Fisher case Overall, the median age was 62 5 (interquartile range (IQR)=54 5-70 5) years, and there were more men (9/102) GBS symptoms started between 5 and 24 days after those of COVID-19 The median protein levels in cerebrospinal fluid samples was 101 5 mg/dl (IQR=51-145) None of the cerebrospinal fluid samples tested positive for COVID-19 Six patients debuted with ascendant weakness and three with facial weakness Five patients had favourable evolution, four remained with relevant symptoms or required critical care and one died;the Miller Fisher case had successful resolution Conclusions: GBS is emerging as a disease that may appear in COVID-19 patients Although limited, preliminary evidence appears to suggest that GBS occurs after COVID-19 onset Practitioners and investigators should have GBS in mind as they look after COVID-19 patients and conduct research on novel aspects of COVID-19 Comparison with GBS patients in the context of another viral outbreak (Zika), revealed similarities and differences that deserves further scrutiny and epidemiological studies
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