Guillain Barré Syndrome associated with SARS‐CoV‐2 infection. A Systematic Review

De Sanctis, Paolo; Doneddu, Pietro Emiliano; Viganò, Luca; Selmi, Carlo; Nobile‐Orazio, Eduardo

BACKGROUND: Guillain‐Barré syndrome (GBS) incidence can increase during outbreaks of infectious illnesses. A few cases of GBS associated with coronavirus disease 2019 (COVID‐19) infection have been reported. To identify specific clinical features of GBS associated with COVID‐19. METHODS: We searched Pubmed, EMBASE and Cochrane from November 1, 2019 to May 17, 2020 and included all papers with full text in English, Spanish, French, or Italian, reporting original data of patients with GBS and COVID‐19. Data were extracted according to a predefined protocol. RESULTS: A total of 18 patients reported in 14 papers were included in this review. All the patients were symptomatic for COVID‐19, with cough and fever as the most frequently reported symptoms. The interval between the onset of symptoms of COVID‐19 and the first symptoms of GBS ranged from ‐8 to 24 days (mean 9 days; median 10 days). Most of the patients had a typical GBS clinical form predominantly with a demyelinating electrophysiological subtype. Mechanical ventilation was necessary in 8 (44%) patients. Two (11%) patients died. CONCLUSIONS: Published cases of GBS associated with COVID‐19 report a sensorimotor, predominantly demyelinating GBS with a typical clinical presentation. Clinical features and disease course seem similar to those observed in GBS related to other etiologies. These results should be interpreted with caution since only 18 cases have been heterogeneously reported so far.