Background Globally, more than 12 million people have been infected with COVID −19 infection till date with more than 500,000 fatalities. Although, Covid-19 commonly presents with marked respiratory symptoms in the form of cough and dyspnoea, a neurotropic presentation has been described of late as well. Objective In this brief communication we report four cases of Covid-19 who presented to our hospital with features suggestive of Guillain-Barre Syndrome (GBS). Discussion The mechanisms by which SARS-CoV-2 causes neurologic damage are multifaceted, including direct damage to specific receptors, cytokine-related injury, secondary hypoxia, and retrograde travel along nerve fibres. The pathogenesis of GBS secondary to Covid-19 is not well understood. It is hypothesised that viral illnesses related GBS could be due to autoantibodies or direct neurotoxic effects of viruses. Conclusion Nervous system involvement in Covid-19 may have been grossly underestimated. In this era of pandemic, it is very important for the physicians to be aware of association of GBS with Covid-19, as early diagnosis and treatment of this complication could have gratifying results. To the best of our knowledge, this is the first such case series of Guillain-Barre Syndrome associated with Covid-19 to be reported from India.

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Epidemiological studies have demonstrated high hospitalization rates attributable to influenza and RSV in children aged 6 months and those aged <12 months, respectively (43 and 92.5/10 000 person-months, respectively). In conclusion, these high paediatric RSV and influenza incidence rates can be used to inform UK policy on childhood influenza immunization and subsequent RSV immunization in the future.

Since the first appearance of Covid-19 in December 2019 in Wuhan, China, the disease has spread world-wide infecting more than 13 million people and causing approximately five hundred eighty-five thousand deaths. The disease which was initially thought to primarily involve respiratory and cardiovascular system only, over time has been reported to involve central and peripheral nervous system with varying frequency. The importance of identifying neurological symptoms cannot be over emphasised by the fact that loss of sense of smell is now considered as one of the earliest features of Covid-19. Although, impaired consciousness has been reported in approximately 17% patients with Covid-19, acute haemorrhagic leukoencephalomyelitis (AHL) as its cause has been reported in a very few cases. It is imperative for the emergency and respiratory physicians to be aware of this condition as mostly they are the ones who initially come in contact with the Covid-19 patients, as early diagnosis and aggressive treatment would greatly help in improving the prognosis and reducing the morbidity in this otherwise fatal disease. We herein report a case of acute haemorrhagic leukoencephalomyelitis secondary to Covid-19 from a tertiary care centre in India. To the best of our knowledge, this is the first case of Covid-19 associated AHL to be reported from India.

Covid-19-associated neurological manifestations are being reported with increased frequency throughout the world. In a study from China, symptoms referable to peripheral nervous system (PNS) were described in approximately 9% of hospitalized Covid-19 patients. Common PNS symptoms reported in the study were loss of taste/smell and muscle pains. With this communication, we expand the spectrum of PNS manifestations of Covid-19 infection by reporting an association of steroid responsive diffuse anterior horn cell disease with Covid-19 infection from a tertiary care centre in India. Neurological manifestations of Covid-19 are diverse, and our case which to best of my knowledge is the first case in literature to report an occurrence of steroid responsive diffuse anterior horn cell disease associated with Covid-19 infection, adds to the ever-increasing spectrum of neurological manifestations associated with this pandemic causing virus. Good response to steroid in our case serves to provide an insight into the possible pathogenesis of this manifestation and also paves the way for future therapeutic decisions related to this association.