Post-COVID-19 chronic inflammatory demyelinating polyneuropathy: a case report of diagnosis and management

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disorder characterized by demyelination and axonal damage in peripheral nerves, leading to progressive weakness and sensory impairment. Neurological complications have been reported in multiple COVID-19 cases, ranging from mild symptoms such as headaches to severe manifestations like demyelination and stroke.

We report the case of a 20-year-old female who initially presented with feverish sensation, non-productive cough, generalized fatigue, arthralgia, and muscle pain. She tested positive for SARS-CoV-2 via polymerase chain reaction and received supportive treatment with home isolation for 20 days. While most symptoms resolved, muscle pain persisted. Over time, the patient developed progressive muscle pain and constant weakness in both upper and lower limbs, worsened by repetitive movement. Additional neurological symptoms included symmetrical foot drop, frequent falls, tremors, and difficulty performing fine motor tasks. Laboratory findings and nerve conduction studies were consistent with CIDP based on established diagnostic criteria. The patient received intravenous immunoglobulin therapy and had residual disability.

Several case reports have associated CIDP with various infectious agents. With the advent of the COVID-19 pandemic, there has been an emergence of CIDP cases following SARS-CoV-2 infection or vaccination. This case adds to the growing body of evidence suggesting a link between COVID-19 and autoimmune neurological complications such as CIDP.

This case highlights a rare instance of post-COVID-19 CIDP, underscoring the importance of considering autoimmune neuropathies in the differential diagnosis of patients presenting with progressive neuromuscular symptoms after COVID-19.