Guillain-Barré Syndrome Associated With Severe Acute Respiratory Syndrome Coronavirus 2 Detection and Coronavirus Disease 2019 in a Child

Abstract

Coronavirus disease (COVID-19) is caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Physicians in China reported what is believed to be the first adult case of a SARS-CoV-2 infection associated with acute Guillain-Barré syndrome (GBS), followed by 5 adult Italian patients and another case in the United States. In the current report, we present one of the first descriptions of an association of GBS and SARS-CoV-2 infection in a child. In our facility, an 11-year-old boy presented with typical features of GBS and, after 5 days, a morbilliform skin rash over the palms of both hands. Three weeks before the start of the neurological symptoms, the boy had experienced an episode of mild febrile illness with mild respiratory manifestations and a persistent cough. The diagnosis of SARS-CoV-2 infection was confirmed by oropharyngeal swab on reverse-transcription polymerase chain reaction assay. The disease course of our patient strongly suggests a possible relationship between the development of GBS and SARS-CoV-2 infection. The case is discussed in view of previous case reports regarding the association of GBS and COVID-19.

Keywords: COVID-19; Guillain-Barré syndrome; SARS-CoV-2; child.

Figure 1.

A and B, Sagittal and axial T1 fat saturation postcontrast magnetic resonance imaging showing cauda equina nerve root enhancement (white arrow) indicative of Guillain-Barré syndrome. C and D, Chest radiograph postanterior and left lateral views showing bilateral paracardiac and basal veiling. E and F, Computed tomography of the chest showing small patchy subsegmental faint opacity with atelectasis band in the lingula on the week after admission (white circles). G, Morbilliform skin rash over the palmar aspect of the left hand.