Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the infectious agent responsible for coronavirus disease 2019 (COVID-19). Respiratory and gastrointestinal manifestations of SARS-CoV-2 are well described, less defined is the clinical neurological spectrum of COVID-19. We reported a case of COVID-19 patient with acute monophasic Guillain-Barré syndrome (GBS), and a literature review on the SARS-CoV-2 and GBS etiological correlation.

Case Description

A 68 years-old man presented to the emergency department with symptoms of acute progressive symmetric ascending flaccid tetraparesis. Oropharyngeal swab for SARS-CoV-2 tested positive. Neurological examination showed bifacial nerve palsy and distal muscular weakness of lower limbs. The cerebrospinal fluid assessment showed an albuminocytologic dissociation. Electrophysiological studies showed delayed distal latencies and absent F waves in early course. A diagnosis of Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) subtype of GBS was then made.

Conclusions

Neurological manifestations of COVID-19 are still under study. The case we described of GBS in COVID-19 patient adds to those already reported in the literature, in support of SARS-CoV-2 triggers GBS. COVID-19 associated neurological clinic should probably be seen not as a corollary of classic respiratory and gastrointestinal symptoms, but as SARS-CoV-2-related standalone clinical entities. To date, it is essential for all Specialists, clinicians and surgeons, to direct attention towards the study of this virus, to better clarify the spectrum of its neurological manifestations.

中文翻译：

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格林-巴利综合征是由 SARS-CoV-2 引发的吗？病例报告和文献综述。

 背景

严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 是导致 2019 年冠状病毒病 (COVID-19) 的传染源。 SARS-CoV-2 的呼吸道和胃肠道表现已得到充分描述，但 COVID-19 的临床神经学谱的定义较少。我们报告了一例患有急性单相吉兰-巴利综合征 (GBS) 的 COVID-19 患者病例，并对 SARS-CoV-2 和 GBS 病因学相关性进行了文献综述。

 案例描述

一名 68 岁男性因急性进行性对称性上行弛缓性四肢轻瘫症状被送往急诊室。口咽拭子 SARS-CoV-2 检测呈阳性。神经系统检查显示双侧神经麻痹和下肢远端肌肉无力。脑脊液评估显示蛋白细胞学解离。电生理学研究显示早期病程远端潜伏期延迟且 F 波缺失。随后诊断为 GBS 急性炎症性脱髓鞘性多发性神经根神经病 (AIDP) 亚型。

 结论

COVID-19 的神经系统表现仍在研究中。我们描述的 COVID-19 患者 GBS 病例对文献中已报道的病例进行了补充，支持 SARS-CoV-2 触发 GBS。 COVID-19 相关的神经科诊所可能不应被视为典型呼吸道和胃肠道症状的必然结果，而应被视为与 SARS-CoV-2 相关的独立临床实体。迄今为止，所有专家、临床医生和外科医生都必须关注这种病毒的研究，以更好地阐明其神经系统表现的范围。