Guillain-Barré Syndrome Following Novel Coronavirus Disease 2019

Yakoby, Jordan; Litvak, Ilya; Yu, Edward

BACKGROUND: : Novel Coronavirus Disease 2019 (COVID-19) has affected more than 89 million people worldwide. As the pandemic rages on, more complications of the disease are recognized including stroke, cardiovascular disease, thromboembolic events, encephalopathy, seizures and more. Peripheral nervous system involvement, particularly Guillain-Barre Syndrome (GBS) are of special interest given the increasing reports of cases related to COVID-19. Because of the potentially delayed onset of symptoms polyradiculoneuropathy and weakness after the traditional COVID-19 symptoms, it is vitally important for emergency physicians to be vigilant and consider this as part of their differential diagnosis. GBS usually occurs after an infectious insult, and a variety of culprit pathogens have been identified in the literature. CASE REPORT: : We describe a case of 35-year-old man who developed GBS after being diagnosed with COVID-19 infection. The patient displayed classic symptoms of neuropathy, areflexia, and lower extremity weakness. CSF evaluation demonstrated albuminocytologic dissociation seen in GBS, though anti-ganglioside autoantibodies were negative. These antibodies are often negative and thus do not exclude the diagnosis. The patient responded clinically to intravenous immunoglobulin therapy and was discharged home. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS? : This case report contributes to further evidence that COVID-19 joins other organisms as causes of GBS. ED physicians are the first point of contact for many patients. Increased awareness of this complication of COVID-19 will lead to higher detection. Prompt recognition could lead to speedier and more complete neurologic recovery of affected patients.