Guillain Barre syndrome associated with COVID-19 infection: A case report

TLDR

COVID‑19, a coronavirus outbreak beginning in December 2019, triggers systemic inflammation and immune responses that may lead to immune‑mediated disorders such as Guillain‑Barré syndrome, though the exact antibody mechanisms remain unclear. The authors report the first case of Guillain‑Barré syndrome in a COVID‑19 patient and call for further investigation into its mechanism. A 65‑year‑old male with confirmed COVID‑19 developed acute progressive symmetric ascending quadriparesis, and electrodiagnostic testing identified the acute motor and sensory axonal neuropathy (AMSAN) variant of Guillain‑Barré syndrome.

Abstract

Novel outbreak with coronavirus 2019 began since 31 December 2019. Coronaviruses can cause multiple systemic infections that respiratory complications are the most obvious symptoms. In this report, we describe the symptoms of Guillain Barre syndrome (GBS) in one infected patient with COVID-19, for the first time. We reported a 65-years- old male patient with complaints of acute progressive symmetric ascending quadriparesis. Two weeks prior to hospitalization, the patient suffered from cough, fever, and RT-PCR was reported positive for COVID-19 infection. The electrodiagnostic test showed that the patient is an AMSAN variant of GBS. COVID-19 stimulates inflammatory cells and produces various inflammatory cytokines and as a result, it creates immune-mediated processes. GBS is an immune-mediated disorder and molecular mimicry as a mechanism of autoimmune disorder plays an important role in creating it. It is unclear whether COVID-19 induces the production of antibodies against specific gangliosides. Further investigations should be conducted about the mechanism of GBS in patients with COVID-19, in the future.