Impact of SARS-CoV-2 Pandemic on the Severity and Outcome of Guillain–Barré Syndrome in Children

Objectives: Following the COVID-19 pandemic, various studies and case reports in adults have proposed an association between COVID-19 and Guillain–Barré syndrome (GBS). We aimed to investigate whether the SARSCOV-2 pandemic had produced an impact on the severity and outcome of GBS in children. Material and Methods: Guillain Barré syndrome (GBS) cases admitted during the COVID-19 pandemic from March 2020 to July 2021 were recruited prospectively, and the case records of children with GBS admitted from July 2018 to February 2020 (before the SARS-COV-2 pandemic) were included in the study for comparison. The Hughes disability score, Medical Research Council (MRC) Score, duration of hospital stay, need for ventilation, need for tracheostomy, death, Erasmus score, need for repeat dose of intravenous immunoglobulin, autonomic symptoms, and cranial nerve involvement were used to assess the severity and outcome of GBS in the 2 groups and also among the different electrophysiological variants of GBS. The data were recorded in an EXCEL sheet and analyzed with the Statistical Package for the Social Sciences software. Ethical committee approval was given by our institutional ethical committee. Results: A total of 31 GBS cases admitted in the 3- 20 months duration before the pandemic (Group A), and 27 cases during the 17 months period during the pandemic (Group B) were enrolled in the study. The mean MRC score at admission among the children in Group A and Group B was 33.74 and 34 ( P = 0.89), respectively. The mean MRC score at discharge was 42 for Group A and 45 for Group B ( P = 0.156). Twenty two percent of the children with GBS in Group A and 16% in Group B required mechanical ventilation ( P = 0.662). Three children in Group A and 2 children in Group B required tracheostomy ( P = 0.759), and 1 child died in each group. The mean Erasmus score was 4 in Group A and 5 in Group B ( P = 0.003), which was statistically significant. The electrophysiological variants revealed acute motor axonal neuropathy accounting for 51% and 48%, and the demyelinating variant (Acute Inflammatory Demyelinating Polyneuropathy) for 26% and 44% of GBS cases before and during the pandemic, respectively ( P = 0.168). Conclusion: SARS-COV-2 pandemic appears to have no impact on GBS presentation, severity, and outcomes in children.