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    Review of 'Manifestation of Guillain-Barre Syndrome After Infection with SARS-CoV-2 versus Other Prior Infections : a Meta-Analysis and Severity Assessment'

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    Manifestation of Guillain-Barre Syndrome After Infection with SARS-CoV-2 versus Other Prior Infections : a Meta-Analysis and Severity AssessmentCrossref
    This manuscript provides new insights into SARS-CoV-2 and non-SARS-CoV-2 GBS.
    Average rating:
        Rated 3.5 of 5.
    Level of importance:
        Rated 3 of 5.
    Level of validity:
        Rated 4 of 5.
    Level of completeness:
        Rated 3 of 5.
    Level of comprehensibility:
        Rated 4 of 5.
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    None

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    Manifestation of Guillain-Barre Syndrome After Infection with SARS-CoV-2 versus Other Prior Infections : a Meta-Analysis and Severity Assessment

    Guillain-Barré Syndrome (GBS) is a rare, autoimmune disease generally triggered by an abnormal immune response to a viral or bacterial infection. Typically, this aberrant immune response targets the nerves, leading to poor nerve signal conduction and damage and manifesting in a variety of physical symptoms. These physical symptoms range from muscle weakness to full paralysis; this intense variability of GBS is not well understood nor comprehensively classified. Our first objective was to provide a better classification method for GBS symptom presentation, and here we present the most specific symptom dependent GBS outcomes severity scale to date. Additionally, the rise of COVID-19 caused an increase in patients who developed GBS after infection with SARS-CoV-2. We applied our novel scoring assessment to 109 total cases of GBS, either induced after SARS-CoV-2 infection or not, to determine if the severity level of the disease manifestation depended on SARS-CoV-2. The results from this analysis show there is no significant difference between the severity of GBS for patients with GBS associated with COVID-19 and GBS without COVID-19 association.
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      Review information

      10.14293/S2199-1006.1.SOR-MED.AX0LIB.v1.RJUQSY
      This work has been published open access under Creative Commons Attribution License CC BY 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com.

      Medicine,Infectious disease & Microbiology
      GBS,Symptoms,Guillain-Barre Syndrome,Clinical Outcomes Scores,Outcomes,COVID-19,SARS-CoV-2,Covid,Guillain-Barre

      Review text

      Thank you for inviting me to review this manuscript.

      This study develops a comprehensive score to assess Guillain-Barre Syndrome (GBS) severity and applies this score to case reports describing GBS from SARS-CoV-2 and non-SARS-CoV-2 causes. In general, the overall findings are of interest, as they indicate that GBS is no more severe when caused by SARS-CoV-2, which may have implications for the clinical management of this disease. Points to consider in a revised manuscript are included below:

      1. In the Introduction section, the authors may consider strengthening the rationale for this study.  Is there reason to hypothesize that GBS in SARS-CoV-2 infected patients would be more sever that GBS caused by other infections.
      2. In the Methods section, additional information on screening of studies would be if interest. Was screening for inclusion/exclusion of articles performed by two independent researchers?
      3. Additional details on the statistical analysis in the methods section would be of interest.
      4. The authors present data on the mean severity score.  It may be of interest to provide data for each clinical criteria (the 5 clinical criteria used in the score) individually between SARS-CoV-2 and non-SARS-CoV-2 causes in order to tease out potential differences in the clinical manifestations of GBS caused by these infections.
      5. The Discussion section addresses important points, but additional discussion on how these results can be placed in the context of previous literature would be of interest.

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