COVID-19 Associated Guillain-Barre Syndrome- A Case Series

ABSTRACT

The outbreak of Coronavirus Disease-2019 (COVID-19) infection with associated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused modified and compromised immune system that gave rise to various immune mediated disease. Various studies on both central and peripheral nervous system involvement has been reported. The common syndromes reported are meningoencephalitis, myelitis and Guillain- Barre syndrome ( GBS) etc. This case series reports four cases (45 years old male, 35 years old female, 50 years old male and 65 years old male patients) presenting with the duration from onset of viral illness to neurologic manifestations ranging from 4 days to 60 days. One patient had a typical course of viral symptoms preceding GBS findings and two patient presented with GBS later. A patient was found to be IgG seropositive for SARS-CoV-2 and presented 2 months later of recovery from infection while one case had onset of weakness while having respiratory symptoms. These cases had Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) who presented with acute flaccid paralysis two to three weeks following COVID-19 infection. All the patients received Intravenous Immunoglobulin (IVIG) as treatment and showed significant improvement. It can be concluded that COVID-19 viral infection is probably related as a causal factor for immune mediated illness like GBS and early identification and treatment has good recovery.