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- Title
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.
- Authors
Garg, Divyani; Dhamija, Rajinder K.; Choudhary, Aditya; Shree, Ritu; Kumar, Sujit; Samal, Priyanka; Pathak, Abhishek; Vijaya, Pamidimukkala; Sireesha, Yareeda; Nair, Sruthi S.; Sharma, Sanjay; Desai, Soaham; Sinha, Human P.; Agarwal, Ayush; Upadhyay, Ashish; Srivastava, M. V. Padma; Bhatia, Rohit; Pandit, Awadh K.; Singh, Rajesh K.; Reyaz, Alisha
- 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.
- Subjects
INDIA; TREATMENT of Guillain-Barre syndrome; RESEARCH; MULTIVARIATE analysis; TREATMENT effectiveness; ARTIFICIAL respiration; ELECTROPHYSIOLOGY; GUILLAIN-Barre syndrome; DESCRIPTIVE statistics; COVID-19 pandemic; LONGITUDINAL method; EVALUATION; SYMPTOMS; CHILDREN
- Publication
Annals of Indian Academy of Neurology, 2022, Vol 25, Issue 1, p60
- ISSN
0972-2327
- Publication type
Article
- DOI
10.4103/aian.aian_392_21