Guillain-Barre Syndrome Secondary to COVID-19: A case report and short review of other published cases

Mukaish Kumar, B. Banik, R. Govindarajan
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Abstract

Background: COVID-19 related Guillain-Barré syndrome has a broad spectrum of presentation. In most reported cases, respiratory symptoms preceded by neurological deficits by one to two weeks, suggesting that the clinical course is mostly post-infectious. In this case report, we present a para-infectious case of GBS with COVID-19. Case presentation: A 37-year-old male patient presented with fever, chills, myalgia, cough, and anosmia. COVID-19 test came positive. He was managed conservatively. On the 7th day of follow-up, he recovered except for a persistent loss of smell and taste. Two weeks after his initial presentation, he reported low back pain and bilateral lower extremity weakness and had a repeat COVID-19 test, which returned positive. His history, physical exam, CSF analysis, nerve conduction, and electromyography test revealed Guillain-Barre Syndrome. We managed GBS with supportive treatment in the hospital, and on follow-up of three months, he recovered fully. Conclusion: In our case, we report a para-infectious case of GBS with C0VID-19, and we managed this case without intravenous immunoglobulin or plasmapheresis. The decision to treat a COVID-19 related GBS case with a traditional GBS treatment option (intravenous immunoglobulin or plasmapheresis) should be taken in conjunction with co-morbidities and a tailored case of case basis.
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COVID-19继发格林-巴利综合征:病例报告和其他已发表病例的简短回顾
背景:与COVID-19相关的格林-巴勒综合征具有广泛的表现。在大多数报告的病例中,呼吸道症状出现之前有一至两周的神经功能障碍,这表明临床病程主要是感染后。在本病例报告中,我们提出了一例伴有COVID-19的GBS副感染病例。病例介绍:一名37岁男性患者,表现为发热、寒战、肌痛、咳嗽和嗅觉丧失。新冠病毒检测呈阳性。他被管理得很保守。随访第7天,患者恢复正常,但嗅觉和味觉持续丧失。初次就诊两周后,他报告腰痛和双侧下肢无力,并再次进行了COVID-19检测,结果呈阳性。病史、体格检查、脑脊液分析、神经传导和肌电图检查显示格林-巴利综合征。我们在医院对他进行了支持性治疗,经过三个月的随访,他完全康复了。结论:在本病例中,我们报告了一例GBS合并covid -19的副感染性病例,我们在没有静脉注射免疫球蛋白或血浆置换的情况下对该病例进行了治疗。在决定是否使用传统的GBS治疗方案(静脉注射免疫球蛋白或血浆置换)治疗与COVID-19相关的GBS病例时,应结合合并症并根据具体情况量身定制。
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