Acute Motor Axonal Neuropathy Variant of Guillain Barre Syndrome: A Rare Presentation of COVID-19

Abstract

Covid-19 has emerged as a pandemic. It originated in December 2019 in China and embraced the globe in the next few months. On January 11^th, China announced the first death from this virus. We describe here one of the rare complications associated with SARS Cov 2. Among the complications reported of Covid-19, Guillain Barre syndrome has been rarely discussed. Most patients are intubated secondary to damaged lung parenchyma or Pulmonary embolism. But If respiratory failure is associated with limb weakness, then GBS should be suspected.

A 65-year-old male presented to us with loose stools, vomiting and fever for a week. On admission he was tested positive for Covid-19. He developed weakness in lower and upper extremities following one week of admission. Nerve conduction studies demonstrated the AMAN variant of GBS. IVIG or PLEX can improve outcome of such patients. Patients who cannot be weaned off should be considered for such therapies.

The novel corona virus can cause variety of symptoms in the host. It can lead to mild symptoms like dry cough, body aches, loss of smell or taste, loose stools and vomiting followed by complete recovery of the patient, or moderate to severe disease-causing shortness of breath and involvement of lung parenchyma. A spectrum of complications can eventually develop like ARDS, multiorgan dysfunction denoting critical disease. Initially it was believed that death occurred from pneumonia and its consequences. Later many patients with stroke were found to be covid positive. The correlation was found to be a thromboembolic phenomenon. Hence anticoagulation was made a part of the regimen of treatment. Now more and more studies are proving the neuro-invasive potential of this virus.