Impact of the COVID-19 pandemic and vaccination on global, regional, and national burden of Guillain-Barré syndrome: observational study

Objectives

To estimate the global, regional, and national burden and trends of Guillain-Barré Syndrome (GBS), and to explore the impact of the COVID-19 pandemic and related public health measures on the GBS burden.

Design

Observational study.

Setting

204 countries and territories.

Data sources

Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 and Our World in Data.

Main outcome measures

All-cause and COVID-19-specific age-standardized years lived with disability (YLD) rates and estimated annual percentage change (EAPC).

Results

Globally, the burden of GBS significantly increased during the COVID-19 pandemic, age-standardized YLD rates were 0.86 (95% uncertainty interval (UI): 0.56 to 1.24) per 100,000 people in 2020, rising to 1.75 (95% UI: 1.12 to 2.54) per 100,000 people in 2021, reflecting an EAPC of 70.35% (95% UI: 38.73 to 109.06) from 2019 to 2021. Regionally, the highest age-standardized YLD rates in 2020 and 2021 were observed in the high-income Asia Pacific and central Latin America, respectively, while the lowest rates were found in East Asia for both years. Age-standardized YLD rates rose 3.7 times faster in countries with a low socio-demographic index (SDI) versus countries with a high SDI (103.21% per year (95% UI: 71.10 to 141.35%) vs 28.02% per year (11.46 to 47.03)). Males generally had higher YLD rates across all age groups, with the highest disparity in those aged 80 and above. During the first two years of the pandemic, the increase in YLD rates was more pronounced in females and younger populations aged 15-29 years. A statistically negative correlation was observed between COVID-19 vaccination coverage and the GBS burden, with increases in full vaccination coverage per 100 people leading to decreases in all-cause YLD rates by 0.0070 and COVID-19-specific YLD rates by 0.0128 per 100,000 people.

Conclusion

Predominantly driven by the surge of COVID-19 cases, the burden of GBS significantly increased during the first two years of the pandemic, especially in those countries with lower SDI levels. Greater increases in the GBS burden were observed in females and younger populations (15-29 years). Importantly, the benefits of vaccination outweighed the risks in controlling the post-COVID-19 GBS burden, although significant disparities in vaccination coverage existed between countries. These findings offer robust evidence facilitating public education and transparent communication on COVID-19 vaccination and highlight the urgency for targeted control measures to manage the burden of post-infection complications, such as GBS, during future COVID-19 waves or other potential pandemics.

WHAT IS ALREADY KNOWN ON THIS TOPIC

Guillain-Barré syndrome (GBS) is an autoimmune disease, and respiratory and gastrointestinal infections are the major triggering factors.

From 1990 to 2019, the burden of GBS was relatively low, with negligible changes observed in most countries and territories.

The impact of the COVID-19 pandemic and vaccination on the burden of GBS remains not fully understood.

WHAT THIS STUDY ADDS

During the COVID-19 pandemic, the global age-standardized years lived with disability (YLD) related to GBS increased by 70.30% annually, and low socio-demographic index (SDI) regions experienced the most rapid GBS burden increment (103.21%).

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was the primary factor contributing to the increased burden of GBS during the COVID-19 pandemic.

Improving vaccination coverage was the most effective measure to reduce the post-COVID-19 burden of GBS, and each additional fully vaccinated person (per hundred people) decreased the COVID-19-specific age-standardized YLD of GBS by 0.0128 per 100,000 population.