# Guillain-Barré Syndrome Associated With COVID-19 Infection: A Case Report and Review of Pathophysiology, Risk Factors, and Management

## TL;DR

This paper reports a case of Guillain-Barré syndrome (GBS) linked to a COVID-19 infection and reviews its possible causes and treatment.

## Contribution

The paper presents a new case of GBS associated with COVID-19 and discusses its pathophysiology and management.

## Key findings

- A 66-year-old man with COVID-19 developed GBS with neurological symptoms and albuminocytological dissociation in cerebrospinal fluid.
- Treatment with intravenous immunoglobulin and remdesivir led to significant clinical improvement and resolution of neurological symptoms.
- The study emphasizes the importance of early diagnosis and intervention for GBS in patients with SARS-CoV-2 infection.

## Abstract

Guillain-Barré syndrome (GBS) is a rare but serious autoimmune neuropathy involving autoimmune destruction of peripheral nerves and rapidly ascending paralysis. Since the start of the COVID-19 pandemic, cases of COVID-19-associated GBS have been increasing in the literature. Although the definitive pathophysiology remains to be studied, SARS-CoV-2 infection is suspected to promote molecular mimicry and induce the development of autoantibodies against peripheral nerves, leading to GBS and its associated manifestations. In this case report, we present a 66-year-old male with a history of coronary artery disease, hypertension, and type II diabetes mellitus, who presented with acute-onset bilateral leg weakness and paresthesia along with a three-day history of fever, chills, and dry cough. The patient tested positive for COVID-19. In addition to his neurological symptoms, cerebrospinal fluid analysis of the patient revealed albuminocytological dissociation, indicating a diagnosis of GBS likely associated with COVID-19 infection. The patient received a five-day course of intravenous immunoglobulin, along with remdesivir and supportive care, for his COVID-19 infection, resulting in significant clinical improvement and complete resolution of his neurological symptoms. This case study examines the potential for GBS to occur in close temporal association with COVID-19 infection and explores the pathophysiology, risk factors, treatment, and preventive measures for COVID-19-associated GBS. Ultimately, our study highlights the importance of clinicians being vigilant for neurological complications, such as Guillain-Barré syndrome (GBS), in patients with SARS-CoV-2 infection, as early diagnosis and intervention can significantly improve patient outcomes and prevent severe complications.