Guillain–Barre syndrome following subclinical COVID-19 infection in a child

Abstract

The entire world is coping up with the challenges imposed by COVID-19 pandemic caused by a novel coronavirus, which started from a single case in Wuhan city of China in November 2019. Its outcomes range from asymptomatic cases to most severe diseases like severe acute respiratory syndrome. Neurological manifestations have also been reported as an outcome of coronavirus infection and Guillain–Barre Syndrome (GBS) is one of them. In our present case, we describe the correlation of GBS with subclinical SARS-CoV-2 in a pediatric patient. The patient was successfully managed with intravenous immunoglobulin and physiotherapy. In the current pandemic, any case of GBS should be evaluated for recent or remote SARS-CoV-2 infection.

Before blaming SARS-CoV-2 for GBS, other causes should be ruled out

“…We read with interest the article by Parikh et al . [ 1 ] about a 2.5-year-old female patient who developed progressive, flaccid quadriparesis that resulted in being unable to stand or walk. Work-up revealed positive IgG-antibodies against SARS-CoV-2, demyelinating neuropathy, and dissociation cyto-albumin.…”

“…Work-up revealed positive IgG-antibodies against SARS-CoV-2, demyelinating neuropathy, and dissociation cyto-albumin. [ 1 ] Guillain–Barre syndrome (GBS) was diagnosed and intravenous immunoglobulins (IVIG) were given with little benefit. [ 1 ] The study is appealing but raises concerns.…”

“…[ 1 ] Guillain–Barre syndrome (GBS) was diagnosed and intravenous immunoglobulins (IVIG) were given with little benefit. [ 1 ] The study is appealing but raises concerns.…”

“…We disagree with the diagnosis of acute SARS-CoV-2 infection. [ 1 ] The patient tested negative for SARS-CoV-2 in the PCR and the rapid antigen test (RAT). [ 1 ] Only neutralizing IgG antibodies were elevated.…”

“…[ 1 ] The patient tested negative for SARS-CoV-2 in the PCR and the rapid antigen test (RAT). [ 1 ] Only neutralizing IgG antibodies were elevated. [ 1 ] Given that neutralizing antibodies can persist for months,[ 2 ] it cannot be ruled out that SARS-CoV-2 infection may have occurred already weeks or months before the onset of GBS, suggesting a causal relationship between SARS-CoV-2 and GBS rather unlikely.…”