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

Objectives: To estimate the global, regional, and national burden and trends of Guillain-Barre 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.