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This study reappraises, after three pandemic years, the epidemiological data and the features of GBS in SARS\u2010CoV\u20102 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review and meta\u2010analysis of case reports\/series and cohort studies published between 1 January 2020 and 19 April 2023 was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 209 case reports\/series (304 patients) and 26 cohort studies were included. The risk of GBS in northern Italy during the first pandemic wave was 2.85 times increased (95% confidence interval [CI] 1.54; 5.25) whereas in some countries the risk during the first pandemic year was 0.17 times reduced (risk ratio 0.83, 95% CI 0.75; 0.93). The incidence of GBS in SARS\u2010CoV\u20102 Italian hospitalized cohorts was 8.55 per 1000 (95% CI 5.33; 12.49) with an estimated incidence of 0.13 GBS per 1000 in the SARS\u2010CoV\u20102 infected population. In European cohorts the pooled rate of GBS with SARS\u2010CoV\u20102 infection was 61.3% of the total. GBS patients with SARS\u2010CoV\u20102 infection showed more frequently, but not differently from non\u2010infected patients, the classical clinical presentation and the demyelinating subtype. Cranial nerves were more frequently involved in SARS\u2010CoV\u20102 infected patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An increased risk of GBS occurred in northern Italy during early COVID\u201019 pandemic. The recognition of the \u2018Italian factor\u2019 reconciles contrasting results of the epidemiological studies. The slightly reduced GBS risk in other countries and the relatively high frequency of GBS associated with SARS\u2010CoV\u20102 infection can be explained by the adopted health measures that decreased the circulation of other GBS infective antecedents.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16094","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T13:05:16Z","timestamp":1697115916000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Guillain\u2212Barr\u00e9 syndrome and <scp>SARS\u2010CoV<\/scp>\u20102 infection: a systematic review and meta\u2010analysis on a debated issue and evidence for the \u2018Italian factor\u2019"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3661-7737","authenticated-orcid":false,"given":"Stefano","family":"Censi","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences; Institute for Advanced Biomedical Technologies (ITAB) \u2018G. d'Annunzio\u2019 University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4606-3093","authenticated-orcid":false,"given":"Giandomenico","family":"Bisaccia","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences; Institute for Advanced Biomedical Technologies (ITAB) \u2018G. d'Annunzio\u2019 University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabina","family":"Gallina","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences; Institute for Advanced Biomedical Technologies (ITAB) \u2018G. d'Annunzio\u2019 University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7368-6280","authenticated-orcid":false,"given":"Valentina","family":"Tomassini","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences; Institute for Advanced Biomedical Technologies (ITAB) \u2018G. d'Annunzio\u2019 University of Chieti\u2010Pescara  Chieti Italy"},{"name":"Clinical Neurology SS. 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