Guillain-Barré Syndrome as a Neurological Complication of Novel COVID-19 Infection

Abstract

Introduction: The novel coronavirus (COVID-19) is a global pandemic. Although the main clinical manifestation of COVID-19 is respiratory involvement, there is evidence suggesting the neuroinvasive potential of COVID-19. There are limited reports of neurological complications of COVID-19 infection in the literature. Herein, we aim to describe 2 members of a family affected by COVID-19, presenting with ascending paresthesia with the final diagnosis of Guillain-Barré syndrome. Case Report: A 38-year-old man presented with a history of ascending paresthesia and bilateral facial droop since 5 days before admission. The medical history was positive for flu-like symptoms affecting all the members of his family. The neurological examination was notable for bilateral peripheral facial paralysis, generalized areflexia, and derceased sensation in distal limbs. The cerebrospinal fluid analysis revealed an albuminocytologic dissociation. In addition, the electromyography-nerve conduction study findings were suggestive of acute axonal-demyelinating polyneuropathy. Meanwhile the patient was treated with a diagnosis of Guillain-Barré syndrome, his 14-year-old daughter presented with a history of progressive paresthesia and weakness. Similar to her father, the paraclinical evaluations were consistent with Guillain-Barré syndrome. Taking into account clinical findings and the outbreak of COVID-19, the suspicion of COVID-19 was proposed. Eventually, on the basis of throat swab samples stand on polymerase chain reaction, the patients were diagnosed with COVID-19. Conclusion: Our cases revealed the familial occurrence of Guillain-Barré syndrome after COVID-19 infection. The authors emphasize neurological complications of COVID-19.

Guillain-Barre syndrome during COVID-19 pandemic: an overview of the reports

“…The data indicate that SARS-CoV-2 is able to cause an immune reaction with an increased level of interleukin-6 (IL-6) which stimulates the inflammatory cascade and damages tissues. Therefore, inflammatory factors may play an important role [51] • Flaccid areflexic tetraplegia evolving to facial weakness, upper limb paresthesia and respiratory failure 27 [51] • Facial diplegia and generalized areflexia evolving to lower limb paresthesia with ataxia 28 [51] • Flaccid tetraparesis and facial weakness evolving to areflexia and respiratory failure 29 [51] • Flaccid areflexic tetraparesis and ataxia 30 [51] • Facial weakness, flaccid areflexic paraplegia, and respiratory failure 31 [52] • Acute progressive paresthesia of distal lower extremities evolving to the upper limbs leading to quardiparesthesia…”

Guillain–Barré syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases

“…1 ). The mean age at onset was 55 ± 17 years (min 11–max 94), including four pediatric cases [ 21 , 27 , 35 , 41 ]. A significative prevalence of men compared to women was noticed (50 vs. 23 cases: 68.5% vs. 31.5%) with no significant difference in age at onset between men and women (mean: 55 ± 18 vs. 56 ± 16 years, p = 0.643).…”

Neurological complications of coronavirus infection; a comparative review and lessons learned during the COVID-19 pandemic

“… 4 Auditory Impairment 2 Articles [ 62 ] [ 57 ] 5 NR in all articles. 5 Glossopharyngeal neuralgia 1 Article [ 57 ] 9 NR GBS and other Neuropathies 6 GBS and GBS variants 36 Articles [ 60 ], [ 63 ], [ 101 ], [ 191 ], [ 215 ], [ 218 ], [ 219 ], [ 220 ], [ 221 ], [ 222 ], [ 223 ], [ 224 ], [ 225 ], [ 226 ], [ 227 ], [ 228 ], [ 229 ], [ 230 ] [ 231 ] [ 232 ] [ 233 ] [ 234 ] [ 235 ] [ 236 ], [ 237 ], [ 238 ], [ 239 ], [ 240 ] [ 241 ] [ 242 ], [ 243 ], [ 244 ] [ 245 ] [ 246 ], [ 247 ], [ 248 ] 52 NR in all articles. Su XW et al [ 226 ], reoorted a patient GBS with dysautonomia.…”