Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol,19: 383-38

Author(s): Zhao H, Shen D, Zhou H, Liu J, Chen S


Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), originating from Wuhan, is spreading around the world and the outbreak continues to escalate. Patients with coronavirus disease 2019 (COVID-19) typically present with fever and respiratory illness.

However, little information is available on the neurological manifestations of COVID-19. Here, we report the first case of COVID-19 initially presenting with acute Guillain-Barré syndrome.

On Jan 23, 2020, a woman aged 61 years presented with acute weakness in both legs and severe fatigue, progressing within 1 day. She returned from Wuhan on Jan 19, but denied fever, cough, chest pain, or diarrhoea. Her body temperature was 36·5°C, oxygen saturation was 99% on room air, and respiratory rate was 16 breaths per min. Lung auscultation showed no abnormalities. Neurological examination disclosed symmetric weakness (Medical Research Council grade 4/5) and areflexia in both legs and feet. 3 days after admission, her symptoms progressed. Muscle strength was grade 4/5 in both arms and hands and 3/5 in both legs and feet. Sensation to light touch and pinprick was decreased distally.

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