Guillaine-Barre syndrome COVID-19 associated

Abstract

Background: Guillain-Barré syndrome (GBS) affects about 100 000 people every year worldwide with the incidence rates of 0.8–1.9 cases per 100000 people annually. A number of case series have reported GBS in association with COVID-19 infection. The aim of our study was to analyse all cases of GBS COVID-19 associated, admitted in a tertiary level neurological hospital. Material and methods: 3 cases with GBS associated with SARS-COV-2 infection were selected. The diagnosis was proved by electromyography (EMG) exam and lumbar puncture. Results: Out of 3, there was 1 female and 2 males with GBS. The registered age was 46, 62 and 67 y.o. Patients developed the disease in 10, 15, and 30 days after the COVID-19 infection. The interval from onset to nadir was 6-9 days. Patients received 5, 10 and 11 points on mEGOS (Modified Erasmus GBS Outcome Score) at day 7 of admission. All patients developed flaccid tetraparesis and “socks” and gloves” sensation loss. Cranial nerves involvement was registered in 2 cases and 2 patients had autonomic disfunction. On EMG, 1 patient was confirmed with axonal polyneuropathy and another 2 with demyelinating polyneuropathy. One patient needed mechanical ventilation. All patients received plasma exchange and 1 benefitted from intravenous immunoglobulins. 1 patient died and other 2 received 4 and 5 points mRS at discharge. Conclusions: GBS COVID-19 associated does not substantially differ from that triggered by other environmental factors.