Para-infectious Guillain Barre Syndrome in a Patient Diagnosed with COVID-19

Abstract

Accumulating evidence suggests the neurotropic characteristics of the SARS-CoV-2. Although the pathogenesis is unclear, the relationship between COVID-19 and Guillain Barre Syndrome(GBS) has been described previously. In this report, a 66-year-old male with para-infectious COVID-19-related GBS admitted with bilateral weakness in distal lower limbs was presented. Five days ago, since he had a risky contact with the COVID-19 patient, the SARS-CoV-2 PCR test was performed and resulted in positive. Favipiravir treatment was given as outpatient therapy. On the fifth day of antiviral treatment, he had applied to Emergency Department with two days of muscle weakness of lower extremities consistent with GBS; hence lumbar punction was performed. The cerebrospinal fluid examination revealed albumin-cytological dissociation. Despite the administration of immunoglobulin infusions, neurological findings worsened, dysphagia, and facial paralysis occurred. Although he was stable for COVID, he was followed up in the intensive care unit for plasmapheresis and then intubated for the respiratory involvement of GBS. Early diagnosis and treatment are critical in GBS related to COVID-19. Since para-infectious COVID-19-related GBS has poor outcomes, clinicians should be aware of this kind of complication to manage patients as it's supposed to be.

Keywords

• covid-19
• para-infectious gbs
• sars cov-2
• guillain barre syndrome.