PEDIATRIC GUILLAIN-BARRÉ SYNDROME IN MÉXICO CLINICAL FEATURES BEFORE AND DURING SARS-COV-2 PANDEMIC

Abstract

Introduction: Guillain-Barré Syndrome is the most common cause of acute flaccid paralysis in childhood. It is a post infectious disease immune-mediated with a rapidly progressive course, usually without relapse. The main features are progressive weakness of more than one limb, areflexia or hyporeflexia, which gets progressively worst over days-to-weeks, to potentially life-threatening severity requiring mechanical ventilation. Objective: We aimed to describe the clinical features of pediatric Guillain-Barré Syndrome in México before and during SARS-CoV-2 pandemic. Methods: We performed an ambispective, observational, cross-sectional study in a Mexican reference hospital from January 2013 to December 2021. Data were obtained through records: demographic, clinical, laboratories, neurophysiological variants and treatment. Results: Here we show that of the 96 patients, 55 were males with mean age of 9 years, 72% had history of infection; progressive weakness was present in 97%, areflexia/hyporeflexia 97%, progression of symptoms 99%, mean cells of 9/mm3 and mean proteins 88 mg/dL. Admission to Pediatric Intensive Care Unit was 20%. Acute Motor Axonal Neuropathy was the most frequent subtype. Nineteen patients required mechanical ventilation. Immunoglobulin was administered in 88%. Most frequent Disability Score at discharge was bedridden/wheelchair-bound. During 2020-2021 we found two SARS-CoV-2 cases and one associated with BNT162b2 vaccine. Conclusions: Our results demonstrate that clinical features of pediatric Guillain-Barré Syndrome are similar before and during SARS-CoV-2 pandemic, nevertheless the number of cases associated with SARS-CoV-2 infection did not find increase.