الفهرس 
Chapter (1): COVID-19Only 14 pages are availabe for public view
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Abstract
In December 2019, the COVID-19 epidemic emerged in Wuhan, China, causing global alterations not only in the field of healthcare, but also in all walks of life. The viral agent responsible for this clinical illness is described as severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). It was documented that SARS-CoV-2 is associated with neurologic manifestations, including headache, dizziness, hypogeusia, and hyposmia. Beside hypogeusia and hyposmia, there has been increased reporting of distinct peripheral nervous system (PNS) diseases in COVID19 patients.
Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy disease of the PNS and the most common cause of flaccid paralysis in the world. It may be triggered by various bacterial and viral infections. Approximately 70% of patients report a recent preceding upper or lower respiratory tract infection or gastrointestinal illness.
Patients with GBS typically present with painful paresthesias and ascending symmetric weakness, with reduced or absent tendon reflexes. Patients can also have cranial nerves involvement and respiratory muscle weakness. Disease progression can be rapid, and most patients with GBS reach their maximum disability within 2 weeks.
GBS can be classified into different distinct clinical variants including classical sensorimotor, paraparetic, Miller Fisher syndrome (MFS), pharyngeal-cervical-brachial variant (PCB), bilateral facial palsy with paranesthesia, and Bickerstaff brainstem encephalitis, acute motor axonal neuropathy (AMAN) and acute motor and sensory axonal neuropathy (AMSAN).
Summary
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Diagnosis of GBS can be challenging owing to heterogeneity in clinical presentation, an extensive differential diagnosis, and the lack of highly sensitive and specific diagnostic tools or biomarkers.
Guidance for the treatment and care of patients with GBS is also needed because disease progression can vary greatly between patients, which complicate an entirely prescriptive approach to management. In addition, treatment options are limited and costly, and many patients experience residual disability and complaints that can be difficult to manage.
The aim of the present study was to compare between COVID associated Gullian Barrie syndrome and Non-COVID associated Gullian Barrie syndrome regarding clinical profile and patient response to treatment with plasma exchange (plasmapheresis).
This was cross sectional study, was conducted at Menoufia University hospital & Shebin Al kom Teaching hospital. Two groups of patients were selected in adequate number over (2020 -2021). The first group of the patients was characterized by having Gullian Barrie Syndrome preceded by COVID-19 infection while the other group of patients was characterized by having Gullian Barrie Syndrome but not preceded by COVID-19 infection.
The main results of the study revealed that:
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There was no statistically significant difference between the studied groups as regard personal data.
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There were 20 (100%) with symptoms of cough, fever, or both, 4 (20%) with anosmia, 3 (15%) with ageusia, 3 (15%) with Myalgia, 3 (15%) with diarrhea, 3 (15%) with odynophagia, 5 (25%) with headache, 2 (10%) with dyspnea.
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There was statistically significant difference between the studied groups as regard period between symptoms to GBS symptoms.
Summary
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There was no statistically significant difference between the studied groups as regard neurological symptoms.
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There was no statistically significant difference between the studied groups as regard neurological examination.
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There was statistically significant difference between the studied groups as regard elevated inflammatory markers and lymphocytopenia.
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There was no statistically significant difference between the studied groups as regard nerve condition.
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There was no statistically significant difference between the studied groups as regard cerebrospinal fluid.
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There was no statistically significant difference between the studied groups as regard ONLS score.
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There was no statistically significant difference between the studied groups as regard Response to treatment by plasma pheresis.
Based on our results we recommend for further studies on larger number of patients and longer period of follow up to emphasize our conclusion.