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

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.

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

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.

Clinical characteristics of COVID-19 patients admitted at the Korle-Bu Teaching Hospital, Accra, Ghana.

The study examined the clinical characteristics and outcomes of 2019 novel coronavirus disease (COVID-19) infections among hospitalized patients. DESIGN: Study design was a retrospective single-center review of hospital data. SETTING: The study was conducted at the COVID-19 Treatment Center of the Department of Medicine and Therapeutics of the Korle-Bu Teaching hospital in Accra, Ghana. PARTICIPANTS AND STUDY TOOLS: A total of fifty patients with laboratory (rRT-PCR) confirmed COVID-19 infection were involved in the study. A chart review of the medical records of the patients was conducted and the data obtained was documented using a data extraction form. RESULTS: The median age was 53 years and most (36% (18/50)) of the patients were at least 60 years of age. Eighty percent (40/50) of the patients were symptomatic, with cough and difficulty in breathing being the commonest presenting symptoms. The mean duration of hospitalization was 12.3 ± 7.3 days. Hypertension and Diabetes Mellitus were the commonest co-morbidities occurring in 52% (26/50) and 42% (21/50) of patients respectively. Fifty percent of patients developed COVID-19 pneumonia as a complication. The mortality rate was 12% (6/50). CONCLUSION: In this study, SARS-CoV2 infection affected older adults with hypertension and diabetes mellitus being the common comorbidities. Patients with these comorbid conditions should be counselled by their clinicians to strictly observe the COVID-19 prevention protocols to reduce their risk of acquiring the infection. There is a need to pay critical and prompt attention to the management of patients with COVID-19 pneumonia particularly among people with diabetes to improve outcomes. FUNDING: None declared.