COVID-19-related and not related Guillain-Barre syndromes share the same management pitfalls during lock down: The experience of Liguria region in Italy
COVID-19-related and not related Guillain-Barre syndromes share the same management pitfalls during lock down: The experience of Liguria region in Italy
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DOI：
10.1016/j.jns.2020.117114
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发表时间：
2020-11-15
影响因子：
4.4
通讯作者：
Benedetti, Luana
中科院分区：
文献类型：
--
作者：
Garnero, Martina;Del Sette, Massimo;Benedetti, Luana
最近，在新型 SARS-CoV-2 大流行感染期间，报告了一些吉兰-巴利综合征 (GBS) 病例。这项工作的目的是报告封锁期间利古里亚地区住院的 GBS 患者（包括新冠病毒和非新冠病毒相关患者）的自然病史，以评估两组的临床特征以及因大流行紧急情况可能出现的管理陷阱。从 2 月份开始，利古里亚医院收治了 15 名 GBS 患者2020 年 15 日至 5 月 3 日，6 名患者感染 SARS-CoV-2，9 名未感染。在 COVID-19 相关 GBS 中，5 名患者出现典型 GBS，1 名患者出现变异型。两名患者在病毒综合征期间或之后不久出现神经系统症状，表明副感染模式。在随访评估中，50% 的 GBS 残疾量表 >= 4 的病例中记录了多器官受累、诊断延迟、检查和开始治疗不完整。在非 COVID-19 相关 GBS 中，主要问题是诊断延迟。三名患者的第一次神经学观察发生在平均 33.6 天后。此外，有 5 名患者因担心传染而在出现神经系统症状后平均 30 天后前往急诊室。 总之，SARS-CoV-2 感染不仅可以导致 GBS，而且由于大流行对卫生组织的影响，它还可能影响非 COVID-19 相关 GBS 患者的结果。
Recently, during the pandemic infection of the novel SARS-CoV-2, some cases of Guillan-Barre Syndrome (GBS) have been reported.The aim of this work is to report the natural history of patients with GBS, both COVID and not-COVID related, hospitalized in Liguria region, during lock down period, in order to assess clinical features of both groups and possible managements pitfalls due to pandemic emergency.Fifteen GBS patients were admitted to the Hospitals of Liguria, from February 15th to May 3rd 2020, six with SARS-CoV-2 infection and nine without infection.In COVID-19 related GBS five patients presented with classical GBS and one with variant. Two patients presented neurologic symptoms during or shortly after the viral syndrome, suggesting the pattern of a para-infectious profile. Multi-organ involvement, delay in the diagnosis, incomplete work up and start of therapy, were registered in 50% of cases with a GBS-Disability scale >= 4 at follow-up evaluation.In not-COVID-19 related GBS, main problem was diagnostic delay. In three patients the first neurological observation took place after a mean of 33,6 days. Moreover, five patients went to emergency room after an average of 30 days since the onset of neurological symptoms because of fear of contagion.In conclusion, not only SARS-CoV-2 infection can cause GBS, but it can also, due to effects of pandemic on the health organization, affect the outcome of patients with not COVID-19 related GBS.