COVID-19-associated Guillain Barre syndrome: Post-infectious alone or neuroinvasive too?

COVID-19 has been shown to be associated with a lot of neurological complications, of whom Guillain Barre syndrome (GBS) is an important post-infectious consequentiality. More than 220 patients of GBS have been reported thus far. We intend to share our experience with 5 patients of GBS where one of them had SARS-Cov-2 in the cerebrospinal fluid (CSF). This is the first ever report demonstrating the presence of SARS-Cov-2 in the CSF of an adult patient; a similar occurrence has recently been described in a pediatric patient. We wish to emphasize the fact that commonly GBS occurs as a result of a post-infectious process but in few cases where the symptoms of COVID-19 and GBS occur concurrently, corresponding to viremic phase, a separate pathogenesis needs to be thought of. This para-infectious nature is exemplified by the presence of virus in the cerebrospinal fluid of one of our patients. We review the neuroinvasive potential of SARS-Cov-2 in this regard and draw parallels with Cytomegalovirus, Zika virus and Human Immunodeficiency virus-associated occurrences of GBS. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.