COVID-19-associated Guillain–Barrè Syndrome and Urinary Dysfunction: A case report

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection can cause multiple systemic and neurological complications, including Guillain- Barrè Syndrome (GBS). In this report we describe for the first time, urinary dysfunction in a patient with COVID- 19. We reported a 41-years- old female patient with complaints of an increased generalized muscular weakness associated with progressive difficulty in walking. Four days earlier, patient complained of fever, diarrhea, and general weakness, and the RT-PCR was positive for COVID-19 infection. Due to the worsening of neurological symptoms, a neurophysiological examination on nervous conduction was performed and the diagnosis was suggestive of GBS. Two weeks later, patient developed two consecutive episodes of acute urinary retention that requested the placement of indwelling transurethral catheter. Patient started assuming selective alpha-1 adrenergic antagonist in association with 4 clean intermittent catheterization/ die. Four months later, women continued the therapy and the ultrasound evaluation revealed non- pathologic post- void residual volume. Therefore, patient started to void spontaneously again and alpha- blockers were discontinued. We report for the first time a case of severe voiding disorder in a patient with COVID-19 associated GBS. Timely bladder drainage should be adopted to avoid irreversible detrusor damage.