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Guillain-Barré Syndrome Associated with SARS-CoV-2 in Two Pediatric Patients
Fatema Al Amrani1, Raghad Al-Abdwani2, Fatma Al Rashdi3
1Pediatric Neurology Unit, Department of Child Health, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.
Insights
Guillain-Barré syndrome (GBS) is a complication of SARS-CoV-2. This report details two pediatric cases in Oman, highlighting rapid progression and the need for mechanical ventilation in GBS associated with COVID-19.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a known cause of Guillain-Barré syndrome (GBS).
- Pediatric GBS cases linked to SARS-CoV-2 require further investigation.
Observation:
- Two children in Oman presented with GBS following SARS-CoV-2 infection in 2021.
- Case 1: An infant with SARS-CoV-2 (PCR positive) developed axonal variant GBS requiring mechanical ventilation.
- Case 2: A child with suspected SARS-CoV-2 (IgG positive) presented with rapidly progressive quadriplegia and respiratory failure.
Findings:
- Both pediatric patients experienced severe GBS with rapid progression.
- Mechanical ventilation was necessary for both cases due to respiratory muscle weakness.
- One patient with axonal variant GBS showed incomplete recovery.
Implications:
- Reinforces GBS as a potential neurological complication of SARS-CoV-2 in children.
- Highlights the need for vigilance in diagnosing and managing GBS in pediatric COVID-19 cases.
- Suggests varied presentations and outcomes of SARS-CoV-2-associated GBS in pediatric populations.
Abstract:
Guillain-Barré syndrome (GBS) is a recognised complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report two children with GBS associated with SARS-CoV-2 who presented to a tertiary centre in Muscat, Oman in 2021: The first patient was a three-month-old female infant who presented with bradypnea, encephalopathy, and generalised weakness that required mechanical ventilation. Polymerase chain reaction (PCR) testing of the nasopharyngeal swabs (NPS) was positive for SARS-CoV-2. She had axonal variant GBS based on a nerve conduction study, cerebrospinal fluid analysis, and neuroimaging findings. The second patient was a six-year-old girl with fever, vomiting, and diarrhea followed by ascending weakness who presented with quadriplegia and facial weakness. Subsequently, she developed respiratory muscle weakness and required mechanical ventilation. PCR testing of NPS was negative for SARS-Cov-2, however IgG serology analysis was positive. The clinical course of these two patients was rapidly progressive and both of them required mechanical ventilation. The patient with axonal variant GBS made an incomplete recovery.
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