COVID-19-associated Guillain‒Barre syndrome: Is it parainfectious or postinfectious?

Abstract

COVID -19 since its inception from the month of December 2019 has been associated with myriads of systemic complication apart from the respiratory failure, with Guillain-Barre syndrome (GBS) being one of the prominent neurological complication. More than 220 patients with GBS have been reported thus far. We wish to share 3 cases of GBS associated with COVID 19 admitted in our institute. GBS is one of the most common causes of acute, acquired weakness and is often provoked by a preceding infection, which triggers an immune response, cross-reacts with shared epitopes on peripheral nerve (molecular mimicry). Interestingly one of the cases developed limb weakness concurrently with the respiratory symptoms, probably during the viremic phase; the other 2 cases few weeks after recovering from COVID 19. So, is there a specific association with covid 19 and GBS? If associated, is it Para infectious or Post infectious? Further studies are needed to unravel its association with COVID 19.