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Título

HOSPITALIZATIONS FOR TREATMENT OF ACUTE DEMYELINATING POLYRADICULONEURITIS AND THE PANDEMIC: A quantitative study

Resumo

Introduction: Acute immune-mediated polyneuropathies, also called Guillain-Barré syndrome (GBS), is one of the main causes of acquired weakness. The pathogenesis occurs when an immune reaction, in response to a previous infection, cross-reacts with shared epitopes in the peripheral nerve. This process generates a clinical condition characterized by symmetric and progressive limb weakness, sensory symptoms and dysautonomia. Some cases require immediate hospitalization, since among the main complications is bulbar weakness, which can lead to respiratory failure. Several cases of GBS associated with COVID-19 have been reported in the literature, although no direct causal relationship has been established. Objective: This article aims to verify if there was an increase in the number of GBS diagnoses in Brazil during the pandemic, looking for a possible causal correlation with COVID-19. Methods: This is a descriptive quantitative study, conducted in the database of the Ministério da Saúde, DATASUS, in the Hospital Procedures section (SIH/SUS) with data on hospitalizations for treatment of acute demyelinating polyradiculoneuritis referring to the period from January 2017 to December 2021. The values were categorized by year of attendance. Data analysis was performed in Microsoft Excel version 2019 program. Results: A reduction in the number of hospitalizations for treatment of acute polyradiculoneuritis was observed during the years 2020 to 2021, characterized by a total of 3740, in relation to the amount found from March 2018 to February 2020, 4362 hospitalizations, with the year 2020 having the lowest hospitalization rate, 21.7%, compared to the total of the period analyzed. About the reduction of expected cases compared to the real data, it is hypothesized that there was a decrease in the number of beds available for treatment of GBS cases due to the resettlement for severe cases of covid. Also, one can speculate about an underreporting of this pathology and, finally, the safety protocols during the period avoided transmission routes for etiological agents of GBS, possibly decreasing its incidence. Conclusion: The data presented point to a lower incidence of GBS in the period. Future studies will be necessary to better understand the relationship between COVID-19 and acute polyradiculoneuritis, which was found to be unassociated by the present study. The lack of specific data for GBS case diagnosis in the DATASUS system was a limitation of the study.

Palavras Chave

Guillain-Barré Syndrome. Hospitalization. COVID-19.