Bibliographic record
Abstract
In this issue of the Canadian Journal of Neurological Sciences, Aladawi et al. describe through a systematic review, a series of patients with Guillain-Barre syndrome (GBS) who presented with evidence of recent COVID-19 infection in the article "Guillain Barre Syndrome as a Complication of COVID-19: A Systematic Review." 1 Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, 2 the authors identified 1,450 records and included 81 studies comprising 109 patients in total.This interesting work included patients diagnosed according to Brighton Collaboration Criteria 3 and excluded patients with preceding infections other than SARS-CoV2, alternative diagnosis for weakness and latency period between COVID-19 infection and GBS symptoms beyond 6 weeks.COVID-19 infection was confirmed in 99 cases with either PCR testing or serology and 77/99 fulfilled a high level of diagnostic certainty for GBS diagnosis (Brighton Criteria 1 or 2), after excluding Miller-Fisher syndrome (MFS) and other variants.GBS cases included classical sensorimotor variants in most patients (64 cases), paraparetic GBS in 16, MFS in 9, and other variants (facial diplegia with paresthesia, pharyngealcervical-brachial GBS, and pure sensory GBS) in the remainder.Nerve conduction studies done showed 59/77 acute inflammatory demyelinating polyneuropathy (AIDP), 8/77 acute motor axonal neuropathy, and 10/77 acute motor and sensory axonal neuropathy.These results parallel data from case series, reviews, cohort, and population-based studies including COVID-19/GBS patients and GBS cases prior to the pandemic, which showed similar age of onset, male predominance, and electrophysiologic profile.[4][5][6][7][8] The authors reported an outstanding male predominance in COVID-19/GBS patients (male: female ratio of 2.5:1) Increased age and male gender are also known risk factors for severe COVID-19 outcomes, including hospitalizations and death, which could reflect the higher prevalence of GBS in hospitalized male patients.9 The most frequent electrophysiologic profile in both COVID-19-related GBS and GBS from other causes is AIDP, making up at least 60% of the cases in most series.1,4,5 In a well-designed cohort study, the predominant electrophysiological subtype was demyelinating in Europe/Americas (55%), while axonal forms predominate in Asian countries, reflecting disparities in clinical presentation.10 Much remains unknown about the strength of the association of GBS and COVID-19 pandemic as compared to prior epidemics/pandemics.For instance, during the Zika virus outbreaks in French Polynesia, a case-control study provided strong evidence of a causative link between the virus and GBS.11 In contrast, Keddie and colleagues did not find a
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.077 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.006 | 0.003 |
| Bibliometrics | 0.008 | 0.004 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.007 | 0.006 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.011 | 0.011 |
| Insufficient payload (model declined to judge) | 0.006 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".