04/19/2020 (Sun) 14:58:17
Guillain-Barre Linked to COVID-19 in Italy
— Five patients developed GBS following COVID-19 infection
by Judy George, Senior Staff Writer, MedPage Today April 17, 2020
GBS is an acquired demyelinating polyneuropathy with an axonal variant, often beginning in the lower extremities and ascending over time, with loss of reflexes. Some cases start a few days or weeks after respiratory or gastrointestinal viral infection. Treatment often is intravenous immunoglobulin (IVIG) or plasmapheresis. Diagnosis may include electromyography and nerve conduction studies; CSF may contain elevated protein but minimal or no cells.
In the Italian cases, GBS symptoms began 5-10 days after the first COVID-19 symptoms. Four patients had onset with lower-limb weakness and paresthesias; one had facial diplegia, then ataxia and paresthesia. Four of the five developed generalized flaccid tetraplegia, and three patients required mechanical ventilation.