Abstract
This multicenter study investigated the epidemiological and clinical characteristics of Guillain-Barré syndrome (GBS) during China’s Omicron wave (December 2022–February 2023), and compared the number of GBS hospitalizations with the historical data for the same period from 2018 to 2022. A retrospective analysis was conducted at two tertiary hospitals, categorizing patients into COVID-GBS (case group) and Non-COVID-GBS (control group). During the Omicron wave, the number of GBS hospitalizations was 1.5 times higher compared to the period of 2018–2019 (99 cases vs. 66 cases). Poisson regression analysis confirmed a significant increase in GBS incidence during the Omicron wave (December 2022–February 2023) compared to the 2018–2019 baseline period, with an IRR of 1.541 (95% CI: 1.123–2.129, p = 0.0079). COVID-19-associated GBS patients were significantly older (54.04 vs. 42.06 years, p = 0.002) and exhibited higher rates of cranial nerve involvement (p = 0.014), particularly bulbar involvement (p = 0.009). Acute severity was greater in COVID-19-associated cases, evidenced by elevated ICU admissions, higher peak GBS disability scores (p = 0.048), increased mechanical ventilation needs, and one fatality. The median latency from COVID-19 infection to neurological onset was 9.5 days (IQR: 8–14). Despite these acute differences, 6-month disability outcomes showed no significant divergence between groups, suggesting similar long-term prognoses. The surge in GBS incidence aligns with broader reports of elevated GBS rates during COVID-19 surges, though mechanistic links may involve immune-mediated pathways rather than direct viral causation.
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Acknowledgements
We sincerely thank the patients who participated in this study and all of those who contributed to this study. We thank the Reviewers for their valuable comments and suggestions. We thank the First Affiliated Hospital of Zhengzhou University and Luoyang Central Hospital for their support.
Funding
This work was supported by China Postdoctoral Science Foundation, Special Funding Project, (2020T130111ZX), Key Project of Luoyang Science & Technology Development Program(2302004 A), Henan Province Health Commission Co-Construction Project (LHGJ20230806).
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Jiwei Zhang: Conceptualization, Supervision, Writing – review & editing. Yifan Guo: Data collection and analysis, Writing – original draft, Writing – review & editing. Liting Wei: Data collection, Writing – review & editing. Jinshun Liu: Writing – review & editing. Shibo Li: Writing – review & editing. Shuo Zhang: Writing – review & editing.
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This study was approved by the Ethics Committees of the First Affiliated Hospital of Zhengzhou University(2024-KY-1665) and Luoyang Central Hospital affiliated with Zhengzhou University. These studies were conducted in accordance with the local legislation and institutional requirements. As this study is retrospective, written informed consent was waived by the First Affiliated Hospital of Zhengzhou University.
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Zhang, J., Guo, Y., Wei, L. et al. Post-COVID-19 surge in Guillain-Barré syndrome during the Omicron wave in China with clinical characteristics and potential immune-mediated pathways. Sci Rep (2026). https://doi.org/10.1038/s41598-026-44136-w
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DOI: https://doi.org/10.1038/s41598-026-44136-w
