Revisión sistemática sobre el síndrome de Guillain Barré asociado a la COVID-19

Héctor Rafael Céspedes Rodríguez, Dania de Jesús Rodríguez Bencomo, Héctor Alejandro Céspedes Rodríguez, Rafael Antonio Céspedes Rodríguez, Antonio Hernández Pérez

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Resumen

Objetivo: Analizar la evidencia disponible sobre la asociación entre la COVID-19 y el síndrome de Guillain Barré.

Adquisición de la evidencia: Se realizó una revisión sistemática guiada por la declaración PRISMA, de artículos publicados en inglés, en la base de datos PubMed, desde enero hasta octubre de 2020, referentes al síndrome de Guillain Barré asociado a la COVID-19. Fueron incluidos en la confección de la base de datos 50 artículos que cumplían los criterios de elegibilidad.

Resultados: Predominaron pacientes mayores de 60 años (46,6 %) y del sexo masculino (63,3 %). La clínica neurológica se presentó, después de la resolución de los síntomas de infección por el COVID-19, en 60 % de los pacientes. El periodo de latencia entre la presentación de las manifestaciones de la COVID-19 y el síndrome de Guillain Barré, y viceversa, fue de 12,4 ± 6,3 días. La mayoría de los pacientes presentaron síndrome de Guillain Barré típico (76,3 %) y el subtipo electrofisiológico más frecuente fue la polineuropatía desmielinizante inflamatoria aguda (46,6 %).

Conclusiones: El número creciente de casos reportados con síndrome de Guillain Barré durante la pandemia de COVID-19 constituye la principal evidencia para señalar a la infección por SARS-CoV2 como agente causal. Las manifestaciones clínicas, variantes y subtipos electrofisiológicos no muestran diferencias con el síndrome de Guillain Barré prepandemia. La variabilidad en la relación temporal entre las manifestaciones de la COVID-19 y el desarrollo del síndrome de Guillain Barré sugiere mecanismos de presentación parainfeccioso y posinfeccioso.

Palabras clave

síndrome de Guillain Barré; síndrome de Miller- Fisher; polineuropatía desmielinizante; COVID-19; degeneración axonal; disfunción autonómica

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