Clinical and Experimental Vaccine Research

The Korean Vaccine Society (대한백신학회)
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Guillain-Barré syndrome associated with SARS-CoV-2 vaccination: how is it different? a systematic review and individual participant data meta-analysis

  • Yerasu Muralidhar Reddy (Department of Neurology, CARE Hospital) ;
  • Jagarlapudi MK Murthy (Department of Neurology, CARE Hospital) ;
  • Syed Osman (Department of Neurology, CARE Hospital) ;
  • Shyam Kumar Jaiswal (Department of Neurology, CARE Hospital) ;
  • Abhinay Kumar Gattu (Department of Neurology, CARE Hospital) ;
  • Lalitha Pidaparthi (Department of Neurology, CARE Hospital) ;
  • Santosh Kumar Boorgu (Department of Neurology, CARE Hospital) ;
  • Roshan Chavan (Department of Neurology, CARE Hospital) ;
  • Bharadwaj Ramakrishnan (Department of Internal Medicine, CARE Hospital) ;
  • Sreekanth Reddy Yeduguri (Department of Neurology, CARE Hospital)
  • Received : 2023.01.01
  • Accepted : 2023.03.31
  • Published : 2023.04.30
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Abstract

Purpose: An association between Guillain-Barré syndrome (GBS) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination has been reported. We aimed to summarize the clinical features of GBS associated with SARS-CoV-2 vaccination and determine the contrasting features from coronavirus disease-19 (COVID-19) associated GBS and GBS following other causes. Materials and Methods: We performed PubMed search for articles published between 1 December 2020 and 27 January 2022 using search terms related to "SARS-CoV-2 vaccination" and "GBS". Reference searching of the eligible studies was performed. Sociodemographic and vaccination data, clinical and laboratory features, and outcomes were extracted. We compared these findings with post-COVID-19 GBS and International GBS Outcome Study (IGOS) (GBS from other causes) cohorts. Results: We included 100 patients in the analysis. Mean age was 56.88 years, and 53% were males. Six-eight received non-replicating virus vector and 30 took messenger RNA (mRNA) vaccines. The median interval between the vaccination and the GBS onset was 11 days. Limb weakness, facial palsy, sensory symptoms, dysautonomia, and respiratory insufficiency were seen in 78.65%, 53.3%, 77.4%, 23.5%, and 25%, respectively. The commonest clinical and electrodiagnostic subtype were sensory-motor variant (68%) and acute inflammatory demyelinating polyneuropathy (61.4%), respectively. And 43.9% had poor outcome (GBS outcome score ≥3). Pain was common with virus vector than mRNA vaccine, and the latter had severe disease at presentation (Hughes grade ≥3). Sensory phenomenon and facial weakness were common in vaccination cohort than post-COVID-19 and IGOS. Conclusion: There are distinct differences between GBS associated with SARS-CoV-2 vaccination and GBS due to other causes. Facial weakness and sensory symptoms were commonly seen in the former and outcomes poor.

Keywords

Acknowledgement

Authors thank Mrs. Vidyavathi for technical assistance.

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