Guillain-Barre Syndrome Secondary to COVID-19 Infection: A Case Report

Abstract

Guillain-Barre syndrome (GBS) is a rare autoimmune disease that often manifests as a post-viral complication. However, its association with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is unclear. We present a rare case of GBS secondary to COVID-19 infection complicated by rapidly progressive sensorimotor deterioration resistant to plasma exchange therapy.

Guillain–Barre syndrome with pleocytosis requires workup for cerebral disease

“…Regarding the cerebrospinal fluid (CSF) findings, we should know why the patient had pleocytosis of 27/3 cells. 1 We should know whether all infectious causes of pleocytosis, including bacterial, viral, fungal, and parasitic meningitis and encephalitis were adequately ruled out. In patients with GBS the CSF cell count is usually normal ("dissociation cyto-albuminuqe").…”

“…1 Despite these measures, the patient deteriorated and developed quadriplegia, respiratory insufficiency, respiratory distress syndrome (ARDS) requiring intubation and mechanical ventilation, and septic shock. 1 The patient was lastly transferred to a long-term acute care hospital for continued management and ventilator weaning. 1 The study is compelling, but has limitations that are cause of concerns and should be discussed.…”

“…We disagree with the notion that SARS-CoV-2 related GBS is a rare disease. 1 On the contrary, there is increasing evidence that GBS can be a complication in adult and pediatric SARS-CoV-2 infections. Several hundred cases of SARS-CoV-2 related GBS have been reported worldwide since onset of the pandemic.…”

“…1 The patient was lastly transferred to a long-term acute care hospital for continued management and ventilator weaning. 1 The study is compelling, but has limitations that are cause of concerns and should be discussed.…”

“…1 The patient was diagnosed with Guillain-Barre syndrome (GBS), subtype acute, motor and sensory, axonal neuropathy (AMSAN) an was treated with steroids and plasmaphereseis (PLEX). 1 Despite these measures, the patient deteriorated and developed quadriplegia, respiratory insufficiency, respiratory distress syndrome (ARDS) requiring intubation and mechanical ventilation, and septic shock. 1 The patient was lastly transferred to a long-term acute care hospital for continued management and ventilator weaning.…”