In a case study published on dovepress.com, a 17 year old girl diagnosed with COVID-19 developed Guillain-Barre syndrome, a neurological disease causing muscle weakness, as her symptoms progressed. While COVID-19 is primarily a respiratory disease that affects breathing and the lungs, a broad array of other symptoms and complications have been reported, including neurological problems such as Guillain-Barre syndrome.
About Guillain-Barre Syndrome
Guillain-Barré syndrome is an autoimmune disease which is characterized by rapid onset muscle weakness. This is caused by the immune system inflicting damage on the peripheral nervous system. The symptoms can appear in a little as a few hours or over the course of a few weeks. The trigger that causes the autoimmune response is linked to an infection of the digestive tract or respiratory tract in most cases. The infections are often linked to Campylobacter jejuni or cytomegalovirus. Other infections can also serve as potential triggers. Symptoms of Guillain-Barré syndrome include sensations like numbness, pain, or tingling, progressive muscle weakness of the arms, legs, and face, pain, and difficulty swallowing. Some patients may experience respiratory failure, which is a medical emergency. Treatment includes interventions to restore breathing ability, immunotherapy, and rehabilitation to restore movement and muscle strength. To learn more about Guillain-Barré syndrome, click here.
In this case, symptoms of the syndrome were pronounced about a week into the COVID-19 disease course. Following pronounced muscle weakness affecting the lower extremities, the patient was admitted to the hospital. The patient also reported shortness of breath for three days, right flank pain lasting a week, and vomiting and decreased urination lasting three days.
The patient was treated with ceftriaxone along with azithromycin but developed respiratory failure. Despite being provided supplemental oxygen, the patient ultimately died from respiratory failure that was considered secondary to Guillian-Barre syndrome.
As cases of neurological disorders in COVID-19 continue to proliferate, a pattern has emerged in which these disorders are often associated with acute respiratory distress syndrome, which can occur with severe COVID-19. More research is necessary to identify a definitive causal relationship between COVID-19 and Guillain-Barre syndrome. IVIG can be a critical intervention that in this case was unfortunately not available at the treatment facility.
Overall, the syndrome should be regarded as a serious but generally rare complication of COVID-19 infection.