{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T18:36:09Z","timestamp":1792866969664,"version":"4.5.0"},"reference-count":57,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Mounting evidence supports an association between Guillain\u2212Barr\u00e9 syndrome spectrum (GBSs) and severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102) infection. However, GBSs in the setting of coronavirus disease 2019 (COVID\u201019) remains poorly characterized, whilst GBSs prevalence amongst COVID\u201019 patients has not been previously systematically evaluated using a meta\u2010analytical approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review and meta\u2010analysis of observational cohort and case series studies reporting on the occurrence, clinical characteristics and outcomes of patients with COVID\u201019\u2010associated GBSs was performed. A random\u2010effects model was used to calculate pooled estimates and odds ratios (ORs) with corresponding 95% confidence intervals (CIs), compared to non\u2010COVID\u201019, contemporary or historical GBSs patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen eligible studies (11 cohorts, seven case series) were identified including a total of 136,746 COVID\u201019 patients. Amongst COVID\u201019 patients, including hospitalized and non\u2010hospitalized cases, the pooled GBSs prevalence was 0.15\u2030 (95% CI 0%\u20130.49\u2030; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a096%). Compared with non\u2010infected contemporary or historical controls, patients with SARS\u2010CoV\u20102 infection had increased odds for demyelinating GBSs subtypes (OR 3.27, 95% CI 1.32%\u20138.09%; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00%). In SARS\u2010CoV\u20102\u2010infected patients, olfactory or concomitant cranial nerve involvement was noted in 41.4% (95% CI 3.5%\u201360.4%; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a046%) and 42.8% (95% CI 32.8%\u201353%; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00%) of the patients, respectively. Clinical outcomes including in\u2010hospital mortality were comparable between COVID\u201019 GBSs patients and non\u2010infected contemporary or historical GBSs controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>GBSs prevalence was estimated at 15 cases per 100,000 SARS\u2010CoV\u20102 infections. COVID\u201019 appears to be associated with an increased likelihood of GBSs and with demyelinating GBSs variants in particular.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14860","type":"journal-article","created":{"date-parts":[[2021,4,10]],"date-time":"2021-04-10T04:42:10Z","timestamp":1618029730000},"page":"3517-3529","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":114,"title":["Prevalence, clinical characteristics and outcomes of Guillain\u2212Barr\u00e9 syndrome spectrum associated with COVID\u201019: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7757-609X","authenticated-orcid":false,"given":"Lina","family":"Palaiodimou","sequence":"first","affiliation":[{"name":"Second Department of Neurology, \u2018Attikon\u2019 University Hospital, School of Medicine National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2305-6627","authenticated-orcid":false,"given":"Maria\u2010Ioanna","family":"Stefanou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u2018Attikon\u2019 University Hospital, School of Medicine National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6359-0023","authenticated-orcid":false,"given":"Aristeidis H.","family":"Katsanos","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u2018Attikon\u2019 University Hospital, School of Medicine National and Kapodistrian University of Athens Athens Greece"},{"name":"Division of Neurology McMaster University\/Population Health Research Institute Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paraskevi C.","family":"Fragkou","sequence":"additional","affiliation":[{"name":"Fourth Department of Internal Medicine, 'Attikon' University Hospital National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u2018Attikon\u2019 University Hospital, School of Medicine National and Kapodistrian University of Athens Athens Greece"},{"name":"Department of Physiotherapy University of West Attica Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4885-1766","authenticated-orcid":false,"given":"Christos","family":"Moschovos","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u2018Attikon\u2019 University Hospital, School of Medicine National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Michopoulos","sequence":"additional","affiliation":[{"name":"Second Department of Psychiatry, \u2018Attikon\u2019 Hospital, School of Medicine National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Kokotis","sequence":"additional","affiliation":[{"name":"First Department of Neurology, \u2018Eginition\u2019 University Hospital, School of Medicine National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Bakirtzis","sequence":"additional","affiliation":[{"name":"Second Department of Neurology Aristotle University of Thessaloniki Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Androniki","family":"Naska","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros I.","family":"Vassilakopoulos","sequence":"additional","affiliation":[{"name":"Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9237-4963","authenticated-orcid":false,"given":"Elisabeth","family":"Chroni","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine University of Patras Rio\u2010Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sotirios","family":"Tsiodras","sequence":"additional","affiliation":[{"name":"Fourth Department of Internal Medicine, 'Attikon' University Hospital National and Kapodistrian University of Athens Athens Greece"},{"name":"Hellenic Centre for Disease Control and Prevention Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-3797","authenticated-orcid":false,"given":"Georgios","family":"Tsivgoulis","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, \u2018Attikon\u2019 University Hospital, School of Medicine National and Kapodistrian University of Athens Athens Greece"},{"name":"Department of Neurology University of Tennessee Health Science Center Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-10124-x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30109-5"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09911-3"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-324837"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa433"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000184748"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00339-1"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-304993"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000324710"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1586\/1744666X.2013.811119"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000781"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1605564"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(01)00019-6"},{"key":"e_1_2_9_15_1","unstructured":"European Centre for Disease Prevention and Control.Case definition for coronavirus disease 2019 (COVID\u201019) as of 3 December 2020.2020. [Available from:https:\/\/www.ecdc.europa.eu\/en\/covid\u201019\/surveillance\/case\u2010definition]. on Dec 18 2020."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.006"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_9_18_1","unstructured":"National Heart Lung and Blood Institute.Study quality assessment tools. [Available from:https:\/\/www.nhlbi.nih.gov\/health\u2010topics\/study\u2010quality\u2010assessment\u2010tools. on 20 December 2020."},{"key":"e_1_2_9_19_1","unstructured":"WellsG SheaB O'ConnellD et al.The Newcastle\u2212Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta\u2010analyses. [Available from:http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.htm. on December 18 2020."},{"key":"e_1_2_9_20_1","unstructured":"Coronavirus Resource Center of the Johns Hopkins University and Medicine.COVID\u201019 Dashboard by the Center for Systems Science and Engineering (CSSE)at Johns Hopkins University (JHU). [Available from:https:\/\/coronavirus.jhu.edu\/map.html. on December 18 2020."},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604.ch10"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v049.i05"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25987"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0233329"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41431-020-0691-z"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12292"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1114525"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcibr2032888"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-300309"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12419"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756286420932036"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102681"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09935-9"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14537"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820926473"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2033369"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30308-2"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14549"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2020.12.011"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.68.3.397"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.7326\/L20-1285"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa444"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu005"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.10.044"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-10108-x"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2020.117118"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.588879"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.11.005"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa240"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009937"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2020.11.013"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2020.117114"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14368"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.26289"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2020.09.029"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2009191"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.14860","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ene.14860","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.14860","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T21:03:11Z","timestamp":1693342991000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.14860"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,28]]},"references-count":57,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1111\/ene.14860"],"URL":"https:\/\/doi.org\/10.1111\/ene.14860","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,28]]},"assertion":[{"value":"2021-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}