Center for Clinical and Translational Research, La Misericordia Clínica Internacional, Barranquilla, Colombia.
Rosalind Russell/Ephraim P Engleman Rheumatology Research Center, University of California, San Francisco, California, USA.
BMC Neurol. 2021 Mar 23;21(1):135. doi: 10.1186/s12883-021-02162-3.
During the Coronavirus disease 2019 (COVID-19) pandemic, different neurological manifestations have been observed. However, only a few cases of Guillain-Barre syndrome (GBS) and COVID-19 have been reported. Therefore, the aim of this study is to investigate a case of concomitant GBS with COVID-19 in Colombia.
A 39-year-old woman was admitted to a teaching hospital in Barranquilla, Colombia with a history of progressive general weakness with lower limb dominance. Previous symptoms such as ageusia, anosmia and intense headache were reported. Upon admission, facial diplegia, quadriparesis with lower extremity predominance and Medical Research Council muscular strength of 2/5 in the lower limbs and 4/5 in the upper limbs were reported. During clinical evolution, due to general areflexia, hypertensive emergency and progressive diaphragmatic weakness, the patient was admitted to an intensive care unit. The cerebrospinal fluid analysis showed protein-cytological dissociation and the GBS diagnosis was confirmed via a nerve conduction and electromyography test. With regard to the symptoms before hospitalisation, SARS-CoV-2 diagnostic testing was performed with positive results in the second test. The patient was managed with supportive care and was discharged after 20 days of hospitalization with clinical improvement.
Only a few cases of COVID-19 with GBS have been reported. Different subtypes have been previously identified, such as Miller-Fisher syndrome and dysautonomic GBS with SARS-CoV-2 infection. This study investigated the first confirmed case of COVID-19 with concomitant GBS in Colombia. In patients with GBS, several viral and bacterial pathogens have been found in case-control studies but the factors that induce the immune-mediated destruction of the nerve tissues have not been determined. Further studies are needed to determine the possible association between COVID-19 exposure and GBS.
在 2019 年冠状病毒病（COVID-19）大流行期间，观察到了不同的神经系统表现。然而，仅有少数 COVID-19 相关格林-巴利综合征（GBS）病例报告。因此，本研究旨在调查哥伦比亚一例同时患有 GBS 和 COVID-19 的病例。
一名 39 岁女性因下肢为主的进行性全身无力入住哥伦比亚巴兰基亚的一所教学医院。此前有报道称她出现味觉丧失、嗅觉丧失和剧烈头痛等症状。入院时，患者表现为面瘫、四肢瘫，下肢以四肢为主，下肢和上肢的医学研究委员会肌肉力量分别为 2/5 和 4/5。在临床演变过程中，由于全身反射消失、高血压危象和进行性膈肌无力，患者被收入重症监护病房。脑脊液分析显示蛋白细胞分离，通过神经传导和肌电图检查确诊为 GBS。关于入院前的症状，对 SARS-CoV-2 进行了诊断性检测，第二次检测结果呈阳性。患者接受了支持性治疗，住院 20 天后，临床症状改善后出院。
仅有少数 COVID-19 合并 GBS 的病例报告。先前已确定了不同的亚型，如 Miller-Fisher 综合征和与 SARS-CoV-2 感染相关的自主神经 GBS。本研究调查了哥伦比亚首例确诊的 COVID-19 合并 GBS 病例。在 GBS 患者中，病例对照研究发现了几种病毒和细菌病原体，但尚未确定导致免疫介导的神经组织破坏的因素。需要进一步的研究来确定 COVID-19 暴露与 GBS 之间的可能关联。
