Guillain-Barre syndrome and pulmonary embolism in an adult female with COVID-19 infection in Ghana: A case report

Abstract

Introduction:The coronavirus disease 2019 (COVID-19) pandemic began at the end of 2019 in Wuhan, the capital of Hubei Province, China. This novel coronavirus is classified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neurological manifestations are commonly associated with moderate to severe COVID-19 infection. Guillain-Barré syndrome (GBS) is a rare immune-mediated postinfectious neuropathy but there has been an increase in the number of cases of GBS associated with COVID-19, supporting the present body of global evidence of the notable association between the 2 conditions. We present the first proven case of GBS and pulmonary embolism associated with COVID-19 infection in Ghana, West Africa.Case Presentation: A 60-year-old apparently healthy female presented in August 2020 to the COVID-19 treatment center of the Korle-Bu Teaching Hospital in Accra, Ghana from a referral facility following a week's history of low-grade fever, chills, rhinorrhoea, and generalized flaccid limb weakness. A positive SARS-CoV-2 test result was recorded 3 days after the onset of symptoms and the patient had no known chronic medical condition. Following cerebrospinal fluid analysis, neurophysiological studies and a chest computed tomography pulmonary angiogram, Guillain-Barre syndrome and pulmonary embolism were confirmed. The patient was however managed supportively and then discharged after 12 days on admission, as he made mild improvement in muscular power and function. Conclusion:This case report adds to the body of evidence of the association between GBS and SARS-CoV-2 infection, particularly from West Africa. It further highlights the need to anticipate potential neurological complications of SARS-CoV-2, particularly GBS even in mild respiratory symptoms for prompt diagnosis and initiation of appropriate therapy to improve outcomes and avert long-term deficits.Abbreviations: COVID-19 = coronavirus disease 2019, CSF = cerebrospinal fluid, GBS = Guillain-Barre syndrome, RT-PCR = reverse transcriptase polymerase chain reaction, SARS-CoV-2 = severe acute respiratory syndrome coronavirus -2.