Clinical case of Guillain-Barré syndrome associated with COVID-19

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Abstract

Background: The coronavirus infection caused by SARS-Cov-2 is characterized by a damage to many organs and systems of the human body. To date, convincing information has been obtained about the involvement of various parts of the nervous system in the pathological process in patients with COVID-19. Among the most frequently described impairments, there are disorders of smell and taste, common disorders of the central nervous system, characterized by general cerebral symptoms, such as headache, asthenization, psychopathological disorders. One of the rare and severe forms of the peripheral nervous system damage in COVID-19 is Guillain-Barre syndrome (GBS), characterized by acute post-infectious inflammatory polyneuropathy with an autoimmune etiology. Clinical case description. We present a clinical case of GBS associated with COVID-19. The disease debuted as a peripheral tetraparesis with a progredient course of up to 21 days. Systemic administration of immunoglobulin stopped the disease progression. The association of GBS with COVID-19 was clarified a month after the disease onset, when bilateral polysegmental pneumonia was diagnosed, and a high level of IgG to the S-protein of SARS-CoV-2 was found, 3 times higher than the level of IgM, which indicated the duration of the disease was not less than three weeks. Conclusion: The GBS development upon infection with SARS-CoV-2 may precede the lung damage. The debut of GBS during the COVID-19 pandemic requires the exclusion of the SARS-CoV-2 etiological role in each case.

About the authors

Elena V. Shirshova

Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies

Author for correspondence.
Email: shirshova.ev@fnkc-fmba.ru
ORCID iD: 0000-0001-9193-0534
SPIN-code: 7491-0434

MD, Dr. Sci. (Med.)

Russian Federation, 28, Orekhovy blvd, Moscow, 115682

Vladimir V. Knaub

Federal Clinical and Research Center for Specialized Medical Care and Medical Technologies of the Federal Medical Biological Agency

Email: knaub.vladimir.v@gmail.com
ORCID iD: 0000-0002-1688-3923

Neurologist

Russian Federation, 28, Orekhovy blvd, Moscow, 115682

Vladimir P. Baklaushev

Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA of Russia

Email: baklaushev.vp@fnkc-fmba.ru
ORCID iD: 0000-0003-1039-4245
SPIN-code: 3968-2971

Dr. Sci. (Med.)

Russian Federation, 28 Orekhovy boulevard, Moscow, 115682

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Supplementary files

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2. Fig. 1. Patient, male, 72 years old: the time course of Guillain–Barré Syndrome.

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3. Fig. 2. The same patient. CT-scan of the chest: (а-в) — In both lungs (in the upper lobe of the left lung, in S2, S4, segments of the lower lobe of the right lung), areas of «ground glass» and consolidation are determined; (г) — Pulmonary embolism of segmental branches on the right (white arrows).

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Copyright (c) 2021 Shirshova E.V., Knaub V.V., Baklaushev V.P.

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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