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RE: Guillain-Barre Syndrome Related to COVID-19 Infection. Comments after 16 published cases

  • Cristina Guijarro-Castro, Neurologist. School of Medicine Professor, CINAC Puerta del Sur
Submitted May 20, 2020

We read with interest the paper by Alberti et al.1 We want to comment on a similar Guillain- Barré Syndrome (GBS) case following bilateral SARS-CoV2 pneumonia and to highlight the evolution of post-infectious GBS.

On May 4th, 2020, a 70-year-old man presented with progressive weakness of all limbs of 5 days of progression, after SARS-CoV-2 infection two weeks before.

Neurologic examination showed asymmetric weakness (Medical Research Council grade 4/5, right hand; 4+/5, left hand; 4/5, left leg and 3+/5, right leg) and areflexia in both legs and feet. Nerve conduction studies (day 6) exhibited delayed distal latencies and absent F waves in early course and albumin-cytological dissociation in CSF. He was diagnosed with GBS and IV immunoglobulins (0.4 g/kg/d for 5 days) were started 8 hours after admission. He evolved favorably and was discharged with minimum deficit.

To date and to our knowledge, three prior cases of GBS concomitant with SARS-CoV-2 infection and a parainfectious profile have been reported1,2,3 and thirteen after SARS-CoV-2 infection2,4 (Table 1). These cases support a causal relationship with SARS-CoV-2 infection.

The Spanish Society of Neurology develops a multicenter nationwide observational study on neurologic presentations and complications of COVID-19.

Disclosure

For disclosures, please contact the editorial office at journal@neurology.org.

References

  1. Alberti P, Beretta S, Piatti M, et al. Guillain-Barré syndrome related to COVID-19 infection. Neurol Neuroimmunol Neuroinflamm 2020;7:e741.
  2. Zhao H, Shen D, Zhou H, Liu J, Chen S. Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol 2020;19:383–384.
  3. Galán AV, Saucedo PDS, Postigo FP, Paniagua EB. Guillain-Barré Syndrome Associated With SARS-CoV-2 Infection. Neurologia 2020; S0213-4853:30072-4.
  4. Toscano G, Palmerini F, Ravaglia S, et al. Guillain–Barré Syndrome Associated with SARS-CoV-2. N Engl J Med 2020 Epub Apr 17.

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