Two case reports and a literature review of typical GBS and rare GBS variants associated with COVID-19

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019, and is the infectious agent that caused the coronavirus disease 2019 (COVID-19) pandemic. Although respiratory and gastrointestinal manifestations of SARS-CoV-2 are well defined, the spectrum of neurological involvement is less defined. The classic type of Guillain-Barré syndrome (GBS) progresses over days to weeks and has a monophasic course. Areflexia/hyporeflexia and ascending and symmetrical paralysis are observed clinically in patients. It is an autoimmune process that typically leads to the destruction of myelin after infection. There have been numerous reports of adult patients with the coexistence of GBS disease and active COVID-19 illness, but this number is lacking for children. In this study, we present a literature review of the etiological correlation between SARS-CoV-2 and GBS and describe the cases of two pediatric patients with acute monophasic Guillain-Barré syndrome (GBS) during active COVID-19 infection.

Keywords: AMAN; Autoimmune; COVID-19; Child; Guillain–Barre syndrome; Myasthenia gravis; Neurological complication; SARS-CoV-2.

Fig. 1

Post-contrast pial brightness (left) in T1 sagittal section at conus medullaris level in spinal magnetic resonance imaging (MRI); pial contrast in conus medullaris/cauda equina in axial T1 section (right).