Long-Term Outcomes of Guillain-Barre Syndrome Associated with Zika Virus Infection (P4.6-025)

Objective: To analyze the long-term functional and neurologic outcomes of patients with Zika virus (ZIKV)-associated Guillain-Barre syndrome (GBS) and compare with non-GBS control subjects in Colombia. Background: GBS has been linked with ZIKV infection; GBS incidence in areas with ZIKV epidemics is higher than expected. Long-term outcomes of ZIKV-associated GBS have been anecdotally described as poorer than expected, but systematic data are lacking. Design/Methods: We enrolled 34 ZIKV-associated GBS cases with acute neurologic onset during spring 2016 in Barranquilla, Colombia, and re-assessed them a median of 17 months later from first report of neurologic onset. Neurologic examinations, and instruments assessing function, mood, and disability were administered. We performed the same assessments on a sampling of Barranquilla residents of similar age and sex distribution who did not develop GBS. Results: Median age of cases at GBS onset was 49 years (range, 10–80); 17 (50%) were male. Proportion of patients with complete recovery (67.6%) was comparable to that described in GBS literature. At follow-up, Hughes GBS Disability score (mean, 1.2, range 0–4), Overall Disability Sum Score (ODSS) (mean 1.2, range 0–7), and Zung Depression Score (mean 34.4, range 20–56) indicated mild / moderate ongoing disability. When compared to the Barranquilla population sample (n=368), ZIKV-associated GBS cases and controls were similar in prevalence of self-reported physical and mental health issues, though GBS patients were more likely to have an ODSS ≥1 (OR 8.8, 95% CI 3.2 – 24.5) indicating ongoing motor weakness, and trended towards reporting restricted activity due to health issues for >10 days in the previous month (OR 2.4, 95%CI 0.7–6.7). Conclusions: Our findings suggest that long-term self-reported physical and mental status among persons with ZIKV-associated GBS after 1 year are similar to persons without GBS, but GBS patients more likely suffer ongoing motor deficits. Further long-term clinical and epidemiologic assessments of ZIKV-associated GBS are needed. Disclosure: Dr. Walteros has nothing to disclose. Dr. Soares has nothing to disclose. Dr. Styczynski has nothing to disclose. Dr. Abrams has nothing to disclose. Dr. Galindo has nothing to disclose. Dr. Acosta-Reyes has nothing to disclose. Dr. Bravo has nothing to disclose. Dr. Arteta has nothing to disclose. Dr. Solano has nothing to disclose. Dr. Prieto has nothing to disclose. Dr. Gonzales has nothing to disclose. Dr. Lechuga has nothing to disclose. Dr. Salinas has nothing to disclose. Dr. Belay has nothing to disclose. Dr. Schonberger has nothing to disclose. Dr. Damon has nothing to disclose. Dr. Ospina has nothing to disclose. Dr. Sejvar has nothing to disclose.