@article {Uncini1105, author = {Antonino Uncini and Jean-Michel Vallat and Bart C Jacobs}, title = {Guillain-Barr{\'e} syndrome in SARS-CoV-2 infection: an instant systematic review of the first six months of pandemic}, volume = {91}, number = {10}, pages = {1105--1110}, year = {2020}, doi = {10.1136/jnnp-2020-324491}, publisher = {BMJ Publishing Group Ltd}, abstract = {A systematic review from 1 January to 30 June 2020 revealed 42 patients with Guillain-Barr{\'e} syndrome (GBS) associated with SARS-CoV-2 infection. Single cases and small series were reported from 13 countries, the majority from Europe (79.4\%) and especially from Italy (30.9\%). SARS-CoV-2 infection was demonstrated by nasopharyngeal swab (85.7\%) and serology (14.3\%). Median time between COVID-19 and GBS onset in 36 patients was 11.5 days (IQR: 7.7{\textendash}16). The most common clinical features were: limb weakness (76.2\%), hypoareflexia (80.9 \%), sensory disturbances (66.7 \%) and facial palsy (38.1\%). Dysautonomia occurred in 19\%, respiratory failure in 33.3\% and 40.5\% of patients were admitted in intensive care unit. Most patients (71.4\%) had the classical clinical presentation but virtually all GBS variants and subtypes were reported. Cerebrospinal fluid (CSF) albumin-cytological dissociation was found in 28/36 (77.8\%) and PCR for SARS-CoV-2 was negative in 25/25 patients. Electrodiagnosis was demyelinating in 80.5\% and levels 1 and 2 of Brighton criteria of diagnostic certainty, when applicable, were fulfilled in 94.5\% patients. Antiganglioside antibodies were positive in only 1/22 patients. Treatments were intravenous immunoglobulin and/or plasma exchange (92.8\%) with, at short-time follow-up, definite improvement or recovery in 62.1\% of patients. One patient died. In conclusion, the most frequent phenotype of GBS in SARS-CoV-2 infection is the classical sensorimotor demyelinating GBS responding to the usual treatments. The time interval between infectious and neuropathic symptoms, absence of CSF pleocytosis and negative PCR support a postinfectious mechanism. The abundance of reports suggests a pathogenic link between SARS-CoV-2 infection and GBS but a case-control study is greatly needed.}, issn = {0022-3050}, URL = {https://jnnp.bmj.com/content/91/10/1105}, eprint = {https://jnnp.bmj.com/content/91/10/1105.full.pdf}, journal = {Journal of Neurology, Neurosurgery \& Psychiatry} }