학술논문
Impact of the COVID-19 pandemic on the frequency, clinical spectrum and outcomes of pediatric guillain-Barré syndrome in India: A multicentric ambispective cohort study
Document Type
article
Author
Divyani Garg; Rajinder K Dhamija; Aditya Choudhary; Ritu Shree; Sujit Kumar; Priyanka Samal; Abhishek Pathak; Pamidimukkala Vijaya; Yareeda Sireesha; Sruthi S Nair; Sanjay Sharma; Soaham Desai; Human P Sinha; Ayush Agarwal; Ashish Upadhyay; M V Padma Srivastava; Rohit Bhatia; Awadh K Pandit; Rajesh K Singh; Alisha Reyaz; P M Yogeesh; Manish Salunkhe; Vivek Lal; Manish Modi; Gagandeep Singh; Monika Singla; Samhita Panda; Maya Gopalakrishnan; Inder Puri; Sudhir Sharma; Bismay Kumar; Prashant K Kushwaha; Harshadkumar Chovatiya; Teresa Ferreira; Sanjeev K Bhoi; Manish Bhartiya; Subhash Kaul; Anuja Patil; Neeharika L Mathukumalli; Madhu Nagappa; P Praveen Sharma; Aneesh Basheer; Dileep Ramachandran; Neetha Balaram; Jospeh Sebastian; Venugopalan Y Vishnu; on behalf of the GBS consortium
Source
Annals of Indian Academy of Neurology, Vol 25, Iss 1, Pp 60-67 (2022)
Subject
Language
English
ISSN
0972-2327
1998-3549
1998-3549
Abstract
Objective: To study impact of COVID-19 pandemic on frequency, clinical/electrophysiological profile and treatment outcomes in pediatric Guillain-Barré syndrome (GBS). Background: GBS is the most frequent cause of pediatric acute flaccid paralysis. The effect of the COVID-19 pandemic on pediatric GBS is unclear in the literature. Methods: We conducted an ambispective, multicentric, cohort study involving 12 of 27 centres in GBS Consortium, during two periods: pre-COVID-19 (March-August 2019) and during COVID-19 (March-August 2020). Children ≤12 years who satisfied National Institute of Neurological Diseases and Stroke criteria for GBS/variants were enrolled. Details pertaining to clinical/laboratory parameters, treatment and outcomes (modified Rankin Scale (mRS) at discharge, GBS Disability score at discharge and 3 months) were analysed. Results: We enrolled 33 children in 2019 and 10 in 2020. Children in 2020 were older (median 10.4 [interquartile range 6.75–11.25] years versus 5 (2.5–8.4) years; P = 0.022) and had more sensory symptoms (50% versus 18.2%; P = 0.043). The 2020 group had relatively favourable mRS at discharge (median 1 (1–3.5) versus 3 (2–4); P = 0.042) and GBS disability score at 3 months (median 0 (0–0.75) versus 2 (0–3); P = 0.009) compared to 2019. Multivariate analysis revealed bowel involvement (P = 0.000) and ventilatory support (P = 0.001) as independent predictors of disability. No child in 2020 had preceding/concurrent SARS-CoV2 infection. Conclusions: The COVID-19 pandemic led to a marked decline in pediatric GBS presenting to hospitals. Antecedent illnesses, clinical and electrophysiological profile of GBS remained largely unchanged from the pre-pandemic era.