Guillain-Barré syndrome (GBS) is a well-established complication of infectious disease. So it is not surprising that several cases have been described during the actual SARS-CoV-2 infection pandemic. Most of the descriptions are patients suffering a severe GBS in the setting of a severe SARS-CoV-2 infection. We described five patients with mild forms of COVID-19. After 2–4 weeks, these patients develop mild neurological symptoms. The clinical and neurophysiological studies supported a diagnosis of an acute polyneuropathy. Symptoms resolved without specific treatment and primary care physicians managed all patients outpatiently. Mild SARS-CoV-2 infection could associate mild neurological complications too. So patients complaining about mild neurological symptoms, a SARS-CoV-2 infection may be excluded.
Supplementary Information
The online version contains supplementary material available at 10.1007/s42399-021-00855-x.
Introduction:Neurological symptoms are common in patients who have suffered a SARS-CoV-2 infection. Cases of Guillain-Barré syndrome as well as sensory symptoms have been published in the context of a long COVID-19 syndrome.Patients and methods:We present 23 patients studied in a Clinical Neurophysiology department. All of them underwent a study of motor and sensory nerve conduction and of the F wave. In those patients with suspected fine fiber pathology, a study of the sympathetic-cutaneous response (SSR) was also performed.Results:In 8 patients alterations were observed in the neurophysiological study (NPS): 2 patients had a delay in the minimum latency of the F wave, 3 patients a decrease in its persistence, 2 patients an absence of SSR and 1 patient a decrease in the amplitude of the sensory action potentials.Patients with alterations in the NPS had a delay between SARS-CoV-2 infection and the appearance of neurological symptoms (median 16 days). Four of them had a self-limiting course and three others developed a long COVID-19 syndrome.In patients with normal NPS, sensory symptoms began at the same time as COVID-19 symptoms. All of them developed a long COVID-19 syndrome.Conclusion:Among these patients we find two profiles: in those with a pathological NPS there is a time delay between SARS-CoV-2 infection and neurological symptoms, often developing self-limiting symptoms. On the other hand, patients with a normal NPS start the neurological symptoms at the same time as the respiratory infection and all of them develop a long COVID-19 syndrome.
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