Guillain-Barré syndrome related to Zika virus infection: A systematic review and meta-analysis of the clinical and electrophysiological phenotype.
Background The Zika virus (ZIKV) has been associated with Guillain-Barré syndrome (GBS) in epidemiological studies. Whether ZIKV-associated GBS is related to a specific clinical or electrophysiological phenotype has not been established. To this end, we performed a systematic review and meta-analysi...
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ftdoajarticles:oai:doaj.org/article:ac66c7b9f9f0430d8149c211e5431ef4 2023-05-15T15:17:42+02:00 Guillain-Barré syndrome related to Zika virus infection: A systematic review and meta-analysis of the clinical and electrophysiological phenotype. Sonja E Leonhard Cristiane C Bresani-Salvi Joanna D Lyra Batista Sergio Cunha Bart C Jacobs Maria Lucia Brito Ferreira Maria de Fatima P Militão de Albuquerque 2020-04-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0008264 https://doaj.org/article/ac66c7b9f9f0430d8149c211e5431ef4 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0008264 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008264 https://doaj.org/article/ac66c7b9f9f0430d8149c211e5431ef4 PLoS Neglected Tropical Diseases, Vol 14, Iss 4, p e0008264 (2020) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2020 ftdoajarticles https://doi.org/10.1371/journal.pntd.0008264 2022-12-31T13:48:05Z Background The Zika virus (ZIKV) has been associated with Guillain-Barré syndrome (GBS) in epidemiological studies. Whether ZIKV-associated GBS is related to a specific clinical or electrophysiological phenotype has not been established. To this end, we performed a systematic review and meta-analysis of all published studies on ZIKV-related GBS. Methods We searched Pubmed, EMBASE and LILACS, and included all papers, reports or bulletins with full text in English, Spanish or Portuguese, reporting original data of patients with GBS and a suspected, probable or confirmed recent ZIKV infection. Data were extracted according to a predefined protocol, and pooled proportions were calculated. Results Thirty-five studies were included (13 single case reports and 22 case series, case-control or cohort studies), reporting on a total of 601 GBS patients with a suspected, probable or confirmed ZIKV infection. Data from 21 studies and 587 cases were available to be summarized. ZIKV infection was confirmed in 21%, probable in 22% and suspected in 57% of cases. ZIKV PCR was positive in 30% (95%CI 15-47) of tested patients. The most common clinical features were: limb weakness 97% (95%CI 93-99), diminished/absent reflexes 96% (95%CI 88-100), sensory symptoms 82% (95%CI 76-88), and facial palsy 51% (95%CI 44-58). Median time between infectious and neurological symptoms was 5-12 days. Most cases had a demyelinating electrophysiological subtype and half of cases were admitted to the Intensive Care Unit (ICU). Heterogeneity between studies was moderate to substantial for most variables. Conclusions The clinical phenotype of GBS associated with ZIKV infection reported in literature is generally a sensorimotor demyelinating GBS with frequent facial palsy and a severe disease course often necessitating ICU admittance. Time between infectious and neurological symptoms and negative PCR in most cases suggests a post-infectious disease mechanism. Heterogeneity between studies was considerable and results may be subject to reporting bias. ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Barré ENVELOPE(-68.550,-68.550,-67.500,-67.500) PLOS Neglected Tropical Diseases 14 4 e0008264 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Sonja E Leonhard Cristiane C Bresani-Salvi Joanna D Lyra Batista Sergio Cunha Bart C Jacobs Maria Lucia Brito Ferreira Maria de Fatima P Militão de Albuquerque Guillain-Barré syndrome related to Zika virus infection: A systematic review and meta-analysis of the clinical and electrophysiological phenotype. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background The Zika virus (ZIKV) has been associated with Guillain-Barré syndrome (GBS) in epidemiological studies. Whether ZIKV-associated GBS is related to a specific clinical or electrophysiological phenotype has not been established. To this end, we performed a systematic review and meta-analysis of all published studies on ZIKV-related GBS. Methods We searched Pubmed, EMBASE and LILACS, and included all papers, reports or bulletins with full text in English, Spanish or Portuguese, reporting original data of patients with GBS and a suspected, probable or confirmed recent ZIKV infection. Data were extracted according to a predefined protocol, and pooled proportions were calculated. Results Thirty-five studies were included (13 single case reports and 22 case series, case-control or cohort studies), reporting on a total of 601 GBS patients with a suspected, probable or confirmed ZIKV infection. Data from 21 studies and 587 cases were available to be summarized. ZIKV infection was confirmed in 21%, probable in 22% and suspected in 57% of cases. ZIKV PCR was positive in 30% (95%CI 15-47) of tested patients. The most common clinical features were: limb weakness 97% (95%CI 93-99), diminished/absent reflexes 96% (95%CI 88-100), sensory symptoms 82% (95%CI 76-88), and facial palsy 51% (95%CI 44-58). Median time between infectious and neurological symptoms was 5-12 days. Most cases had a demyelinating electrophysiological subtype and half of cases were admitted to the Intensive Care Unit (ICU). Heterogeneity between studies was moderate to substantial for most variables. Conclusions The clinical phenotype of GBS associated with ZIKV infection reported in literature is generally a sensorimotor demyelinating GBS with frequent facial palsy and a severe disease course often necessitating ICU admittance. Time between infectious and neurological symptoms and negative PCR in most cases suggests a post-infectious disease mechanism. Heterogeneity between studies was considerable and results may be subject to reporting bias. ... |
format |
Article in Journal/Newspaper |
author |
Sonja E Leonhard Cristiane C Bresani-Salvi Joanna D Lyra Batista Sergio Cunha Bart C Jacobs Maria Lucia Brito Ferreira Maria de Fatima P Militão de Albuquerque |
author_facet |
Sonja E Leonhard Cristiane C Bresani-Salvi Joanna D Lyra Batista Sergio Cunha Bart C Jacobs Maria Lucia Brito Ferreira Maria de Fatima P Militão de Albuquerque |
author_sort |
Sonja E Leonhard |
title |
Guillain-Barré syndrome related to Zika virus infection: A systematic review and meta-analysis of the clinical and electrophysiological phenotype. |
title_short |
Guillain-Barré syndrome related to Zika virus infection: A systematic review and meta-analysis of the clinical and electrophysiological phenotype. |
title_full |
Guillain-Barré syndrome related to Zika virus infection: A systematic review and meta-analysis of the clinical and electrophysiological phenotype. |
title_fullStr |
Guillain-Barré syndrome related to Zika virus infection: A systematic review and meta-analysis of the clinical and electrophysiological phenotype. |
title_full_unstemmed |
Guillain-Barré syndrome related to Zika virus infection: A systematic review and meta-analysis of the clinical and electrophysiological phenotype. |
title_sort |
guillain-barré syndrome related to zika virus infection: a systematic review and meta-analysis of the clinical and electrophysiological phenotype. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2020 |
url |
https://doi.org/10.1371/journal.pntd.0008264 https://doaj.org/article/ac66c7b9f9f0430d8149c211e5431ef4 |
long_lat |
ENVELOPE(-68.550,-68.550,-67.500,-67.500) |
geographic |
Arctic Barré |
geographic_facet |
Arctic Barré |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 14, Iss 4, p e0008264 (2020) |
op_relation |
https://doi.org/10.1371/journal.pntd.0008264 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008264 https://doaj.org/article/ac66c7b9f9f0430d8149c211e5431ef4 |
op_doi |
https://doi.org/10.1371/journal.pntd.0008264 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
14 |
container_issue |
4 |
container_start_page |
e0008264 |
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