SARS-CoV-2-associated Guillain-Barré syndrome: a descriptive and comparative analysis

Cárdenas-Rodríguez, Marco Antonio; Meléndez-Flores, Jesús D.; Villarreal-Garza, Estefanía; Flores-Alfaro, Fernanda; Pérez-Arzola, Alan Alberto; Fuente-Martínez, Jorge Alberto De la; González-Dávila, Santiago Elizandro; Chávez-Luévanos, Beatriz; Estrada‐Bellmann, Ingrid

doi:10.1017/cjn.2021.504

Cited by 1 publication

(2 citation statements)

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“…Most published papers regarding diagnosis, prognosis, and treatment of patients with GBS derive from either exclusive or predominant cohorts with AIDP, 2,16,30-32 which might be a limitation when extrapolating results in Asian or Latin American populations regarding treatment response and outcomes. [9][10][11][12][13][14][15][34][35][36] Therefore, there is an urgent need to study whether treatment responses and outcomes apply in the same way as it has been described in patients with the classical AIDP. In our present report, we demonstrate that the clinical presentation is of utmost importance when classifying the risk of respiratory failure in GBS patients with a high frequency of AMAN and AMSAN variants.…”

Section: Discussionmentioning

confidence: 99%

“…This frequency appears to be more comparable to what was observed in non-Western populations such as Central and South America, and Asian countries, in that axonal subtypes account for 30-56% of cases. [9][10][11][12][13][14][15][34][35][36] Despite not being an independent predictor when including in the multivariate model to published grading scales, the axonal variants had more cases of respiratory failure than the classical GBS, AIDP. This finding contrasts with other reports that patients with AIDP needed IMV significantly more frequently than those without AMAN/AMSAN.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Mechanical Ventilation in Guillain–Barré Syndrome with Axonal Subtypes

Michel-Chávez

Chiquete

Gulı́as-Herrero

et al. 2022

Can. J. Neurol. Sci.

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Background: The early clinical predictors of respiratory failure in Latin Americans with Guillain–Barré syndrome (GBS) have scarcely been studied. This is of particular importance since Latin America has a high frequency of axonal GBS variants that may imply a worse prognosis. Methods: We studied 86 Mexican patients with GBS admitted to the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, a referral center of Mexico City, to describe predictors of invasive mechanical ventilation (IMV). Results: The median age was 40 years (interquartile range: 26–53.5), with 60.5% men (male-to-female ratio: 1.53). Most patients (65%) had an infectious antecedent (40.6% gastrointestinal). At admission, 38% of patients had a Medical Research Council (MRC) sum score <30. Axonal subtypes predominated (60.5%), with acute motor axonal neuropathy being the most prevalent (34.9%), followed by acute inflammatory demyelinating polyneuropathy (32.6%), acute motor sensory axonal neuropathy (AMSAN) (25.6%), and Fisher syndrome (7%). Notably, 15.1% had onset in upper limbs, 75.6% dysautonomia, and 73.3% pain. In all, 86% received either IVIg (9.3%) or plasma exchange (74.4%). IMV was required in 39.5% patients (72.7% in AMSAN). A multivariate model without including published prognostic scores yielded the time since onset to admission <15 days, axonal variants, MRC sum score <30, and bulbar weakness as independent predictors of IMV. The model including grading scales yielded lower limbs onset, Erasmus GBS respiratory insufficiency score (EGRIS) >4, and dysautonomia as predictors. Conclusion: These results suggest that EGRIS is a good prognosticator of IMV in GBS patients with a predominance of axonal electrophysiological subtypes, but other early clinical data should also be considered.

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