Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world, causing a pandemic that has resulted in more than 5 million deaths globally. The gastrointestinal (GI) tract is known to have high expression of angiotensin-converting enzyme 2 (ACE2) receptors in the human body, making it prone to direct damage from the cellular invasion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Numerous GI symptoms have been reported among patients with COVID-19. This systemic review details the mechanism and effects of COVID-19 on the GI tract along with the hepatobiliary and pancreatic systems.
Novel outbreaks with COVID-19 can cause multiple systemic manifestations, including autoimmune disease. Among all the infections, respiratory complications are the most apparent symptoms. Guillain-Barre syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy often related to previous infectious exposure. GBS emerged as a potentially severe complication of coronavirus disease 2019 (COVID-19) since its declaration as a global pandemic. We report the first case of COVID-19-induced acute motor axonal neuropathy variant of Guillain-Barre syndrome (GBS) from New York, USA. Our patient was a 66-year-old woman who had recently tested positive for COVID-19 and presented with bilateral upper and lower extremity weakness. Electromyogram studies showed acute demyelinating polyradiculoneuropathy. She was diagnosed with an acute motor axonal neuropathy variant of GBS. She was successfully treated with intravenous immunoglobulins (IVIGs) with marked improvement. In six months, she regained her strength back to normal. Whether GBS incidence in COVID-positive patients is based on molecular mimicry or antiganglioside antibodies is unclear. Physicians should be aware of GBS as a potentially serious complication associated with COVID-19. Further investigations and trials should be conducted better to understand the mechanism of GBS in patients of COVID-19.
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