COVID-19-associated Guillain–Barre syndrome: A case series with review of literature

Abstract

Globally, millions of people are rapidly infected with COVID-19 and it has spread worldwide from January 2020 to till date. Coronavirus mostly affects the respiratory system; it can also result in several multisystem complications. This is a case series of four patients admitted in the department of medicine with post-COVID-19 Guillain–Barre syndrome (GBS). SARS-CoV-2 mainly affects the respiratory system but multiple organ damage is being reported recently, neurologic damage is one of them. SARS-CoV-2 causes neurologic damage including, by direct attack the nervous system through angiotensin-converting enzyme receptor, secondary to an immune reaction against SARS-CoV-2, retrograde transport, cytokine, and hypoxia-related injury. However, pathogenesis is not fully understood. It is hypothesized that the cause of GBS in covid patients is due to immune-mediated. It is hypothesized that inflammatory cytokines may play a role in an immune-mediated neuropathy. In this era of pandemic, we are concern about the involvement of respiratory and gastrointestinal systems only, involvement of other systems is underestimated. It is very important to be aware of association of GBS with COVID-19. Although neurological involvement in COVID-19 is rare, early diagnosis and treatment can reduce morbidity and mortality. We should always think about COVID-19 infection in a patients presented with GBS after respiratory or gastrointestinal involvement.