COVID-19-associated Guillain-Barré syndrome in the early pandemic experience in Lombardia (Italy)

Objective To estimate the incidence and describe clinical characteristics and outcome of GBS in COVID-19 patients (COVID19-GBS) in one of the most hit regions during the frst pandemic wave, Lombardia. Methods Adult patients admitted to 20 Neurological Units between 1/3–30/4/2020 with COVID19-GBS were included as part of a multi-center study organized by the Italian society of Hospital Neuroscience (SNO). Results Thirty-eight COVID19-GBS patients had a mean age of 60.7 years and male frequency of 86.8%. CSF albuminocytological dissociation was detected in 71.4%, and PCR for SARS-CoV-2 was negative in 19 tested patients. Based on neurophysiology, 81.8% of patients had a diagnosis of AIDP, 12.1% of AMSAN, and 6.1% of AMAN. The course was favorable in 76.3% of patients, stable in 10.5%, while 13.2% worsened, of which 3 died. The estimated occurrence rate in Lombardia ranges from 0.5 to 0.05 GBS cases per 1000 COVID-19 infections depending on whether you consider positive cases or estimated seropositive cases. When we compared GBS cases with the pre-pandemic period, we found a reduction of cases from 165 to 135 cases in the 2-month study period in Lombardia. Conclusions We detected an increased incidence of GBS in COVID-19 patients which can refect a higher risk of GBS in COVID-19 patients and a reduction of GBS events during the pandemic period possibly due to a lower spread of more common respiratory infectious diseases determined by an increased use of preventive measures

Covid-19-associated Guillain-Barré syndrome in the first wave of COVID-19 pandemic in Lombardia: Increased incidence or increased seroprevalence?

38noembargoed_20221015embargoed_20221015Filippo Martinelli Boneschi; Antonio Colombo; Nereo Bresolin; Maria Sessa; Mattia Pozzato; Giampiero Grampa; Pietro Bassi; Eugenio Magni; Maurizio Versino; Carlo Ferrarese; Davide Zarcone; Alberto Albanese; Giuseppe Micieli; Carla Zanferrari; Antonio Cagnana; Claudio Ferrante; Angelo Zilioli; Davide Locatelli; Maria Calloni; Maria Luisa Delodovici; Camillo Foresti; Barbara Frigeni; Stefania Canella; Rubjona Xhani; Massimo Crabbio; Alessandro Clemenzi; Marco Mauri; Simone Beretta; Isidoro La Spina; Simona Bernasconi; Anna Cavallini; Michela Ranieri; Elisabetta D{ extquotesingle}Adda; Maria Elisa Fruguglietti; Lorenzo Peverelli; Edoardo Agosti; Andrea Rigamonti; Andrea SalmaggiMartinelli Boneschi, Filippo; Colombo, Antonio; Bresolin, Nereo; Sessa, Maria; Pozzato, Mattia; Grampa, Giampiero; Bassi, Pietro; Magni, Eugenio; Versino, Maurizio; Ferrarese, Carlo; Zarcone, Davide; Albanese, Alberto; Micieli, Giuseppe; Zanferrari, Carla; Cagnana, Antonio; Ferrante, Claudio; Zilioli, Angelo; Locatelli, Davide; Calloni, Maria; Luisa Delodovici, Maria; Foresti, Camillo; Frigeni, Barbara; Canella, Stefania; Xhani, Rubjona; Crabbio, Massimo; Clemenzi, Alessandro; Mauri, Marco; Beretta, Simone; La Spina, Isidoro; Bernasconi, Simona; Cavallini, Anna; Ranieri, Michela; D( extquotesingle)Adda, Elisabetta; Elisa Fruguglietti, Maria; Peverelli, Lorenzo; Agosti, Edoardo; Rigamonti, Andrea; Salmaggi, Andre

Risk of Guillain-Barr\ue9 syndrome after 2010-2011 influenza vaccination

Influenza vaccination has been implicated in Guillain Barr\ue9 Syndrome (GBS) although the evidence for this link is controversial. A case-control study was conducted between October 2010 and May 2011 in seven Italian Regions to explore the relation between influenza vaccination and GBS. The study included 176 GBS incident cases aged 6518 years from 86 neurological centers. Controls were selected among patients admitted for acute conditions to the Emergency Department of the same hospital as cases. Each control was matched to a case by sex, age, Region and admission date. Two different analyses were conducted: a matched case-control analysis and a self-controlled case series analysis (SCCS). Case-control analysis included 140 cases matched to 308 controls. The adjusted matched odds ratio (OR) for GBS occurrence within 6 weeks after influenza vaccination was 3.8 (95 % CI: 1.3, 10.5). A much stronger association with gastrointestinal infections (OR = 23.8; 95 % CI 7.3, 77.6) and influenza-like illness or upper respiratory tract infections (OR = 11.5; 95 % CI 5.6, 23.5) was highlighted. The SCCS analysis included all 176 GBS cases. Influenza vaccination was associated with GBS, with a relative risk of 2.1 (95 % CI 1.1, 3.9). According to these results the attributable risk in adults ranges from two to five GBS cases per 1,000,000 vaccinations