Impact of COVID-19 on Guillain Barre Syndrome (GBS) insights from an Iranian referral center.

Background: The COVID-19 pandemic has raised concerns about various neurological complications, including Guillain-Barré syndrome (GBS). Understanding the characteristics and incidence of GBS during this period is crucial for clinical management and public health response. Objective: This study aims to analyze the characteristics of GBS cases reported at an Iranian referral center during the COVID-19 pandemic and assess the relationship between GBS, COVID-19 infection, and vaccination. Methods: We conducted a retrospective analysis of GBS cases referred to our center between 2018 and 2023. Clinical data, including demographic information, neurophysiological subtypes, COVID-19 and vaccination associated cases and outcomes were collected and analyzed. The frequency of GBS admission during pandemic compared with previous years. Characteristics of COVID-19 associated GBS and those vaccinated for COVID-19 was compared. Results: A total of 334 patients were included to study. Our analysis revealed a notable increase in GBS cases during the pandemic. The incidence of vaccine-related GBS was significantly lower than that of GBS related to COVID-19 infection. Additionally, GBS patients diagnosed with COVID-19 presented more severe symptoms compared to those who developed GBS after vaccination. Conclusion: Although the incidence of GBS increased during the COVID-19 pandemic at our center, it remains a rare complication of both COVID-19 and its vaccination. These findings highlight the need for ongoing surveillance of neurological complications during infectious disease outbreaks and vaccination campaigns.