Abstract
Background:
 COVID-19 related Guillain-Barré syndrome has a broad spectrum of presentation. In most reported cases, respiratory symptoms preceded by neurological deficits by one to two weeks, suggesting that the clinical course is mostly post-infectious. In this case report, we present a para-infectious case of GBS with COVID-19.
 Case presentation:
 A 37-year-old male patient presented with fever, chills, myalgia, cough, and anosmia. COVID-19 test came positive. He was managed conservatively. On the 7th day of follow-up, he recovered except for a persistent loss of smell and taste. Two weeks after his initial presentation, he reported low back pain and bilateral lower extremity weakness and had a repeat COVID-19 test, which returned positive. His history, physical exam, CSF analysis, nerve conduction, and electromyography test revealed Guillain-Barre Syndrome. We managed GBS with supportive treatment in the hospital, and on follow-up of three months, he recovered fully.
 Conclusion:
 In our case, we report a para-infectious case of GBS with C0VID-19, and we managed this case without intravenous immunoglobulin or plasmapheresis. The decision to treat a COVID-19 related GBS case with a traditional GBS treatment option (intravenous immunoglobulin or plasmapheresis) should be taken in conjunction with co-morbidities and a tailored case of case basis.
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