PT - JOURNAL ARTICLE AU - Massimiliano Filosto AU - Stefano Cotti Piccinelli AU - Stefano Gazzina AU - Camillo Foresti AU - Barbara Frigeni AU - Maria Cristina Servalli AU - Maria Sessa AU - Giuseppe Cosentino AU - Enrico Marchioni AU - Sabrina Ravaglia AU - Chiara Briani AU - Francesca Castellani AU - Gabriella Zara AU - Francesca Bianchi AU - Ubaldo Del Carro AU - Raffaella Fazio AU - Massimo Filippi AU - Eugenio Magni AU - Giuseppe Natalini AU - Francesco Palmerini AU - Anna Maria Perotti AU - Andrea Bellomo AU - Maurizio Osio AU - Giuseppe Scopelliti AU - Marinella Carpo AU - Andrea Rasera AU - Giovanna Squintani AU - Pietro Emiliano Doneddu AU - Valeria Bertasi AU - Maria Sofia Cotelli AU - Laura Bertolasi AU - Gian Maria Fabrizi AU - Sergio Ferrari AU - Federico Ranieri AU - Francesca Caprioli AU - Elena Grappa AU - Laura Broglio AU - Giovanni De Maria AU - Ugo Leggio AU - Loris Poli AU - Frank Rasulo AU - Nicola Latronico AU - Eduardo Nobile-Orazio AU - Alessandro Padovani AU - Antonino Uncini TI - Guillain-Barré syndrome and COVID-19: an observational multicentre study from two Italian hotspot regions AID - 10.1136/jnnp-2020-324837 DP - 2021 Jul 01 TA - Journal of Neurology, Neurosurgery & Psychiatry PG - 751--756 VI - 92 IP - 7 4099 - http://jnnp.bmj.com/content/92/7/751.short 4100 - http://jnnp.bmj.com/content/92/7/751.full SO - J Neurol Neurosurg Psychiatry2021 Jul 01; 92 AB - Objective Single cases and small series of Guillain-Barré syndrome (GBS) have been reported during the SARS-CoV-2 outbreak worldwide. We evaluated incidence and clinical features of GBS in a cohort of patients from two regions of northern Italy with the highest number of patients with COVID-19.Methods GBS cases diagnosed in 12 referral hospitals from Lombardy and Veneto in March and April 2020 were retrospectively collected. As a control population, GBS diagnosed in March and April 2019 in the same hospitals were considered.Results Incidence of GBS in March and April 2020 was 0.202/100 000/month (estimated rate 2.43/100 000/year) vs 0.077/100 000/month (estimated rate 0.93/100 000/year) in the same months of 2019 with a 2.6-fold increase. Estimated incidence of GBS in COVID-19-positive patients was 47.9/100 000 and in the COVID-19-positive hospitalised patients was 236/100 000. COVID-19-positive patients with GBS, when compared with COVID-19-negative subjects, showed lower MRC sum score (26.3±18.3 vs 41.4±14.8, p=0.006), higher frequency of demyelinating subtype (76.6% vs 35.3%, p=0.011), more frequent low blood pressure (50% vs 11.8%, p=0.017) and higher rate of admission to intensive care unit (66.6% vs 17.6%, p=0.002).Conclusions This study shows an increased incidence of GBS during the COVID-19 outbreak in northern Italy, supporting a pathogenic link. COVID-19-associated GBS is predominantly demyelinating and seems to be more severe than non-COVID-19 GBS, although it is likely that in some patients the systemic impairment due to COVID-19 might have contributed to the severity of the whole clinical picture.Data are available upon reasonable request.