Vol. 5, Issue 1, Part A (2023)

Background: Coronavirus (COVID-19) appeared in China in December 2019, with neuromuscular complications including: acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), Miller Fisher syndrome and polyneuritis cranialis, pharyngeal-cervical-brachial variant of GBS, facial diplegia and myositis.

Methods: The study included 71 GBS cases which were divided into three groups: GBS following COVID-19 infection, GBS following COVID-19 vaccine and GBS without COVID vaccine or infection and also included a few number of other neuromuscular disorders as myathenis gravis and inflammatory myositis.

Results: Preceding diarrhea was significantly higher in infection group and control group than vaccine group. EGOS1, EGOS2, EGRIS, NEDS mean values were significantly lower in vaccine group. Total MRC was of significantly higher value in vaccine group. Olfactory nerve and bulbar affection were significantly higher in infection group. Pattern of neuropathy was predominantly sensorimotor axonal in the 3 groups. CSF proteins showed higher level in infection and control groups. There was no significant difference in response to plasma exchange or IVIG in 3 groups. Other COVID positive cases were de novo diagnosed as MG and myositis.

Conclusion: There were milder symptoms with better outcome in vaccine group with no specific pattern of clinical presentation in each group or superiority of one modality of treatment over the other. Also, our study included few other cases of de novo neuromuscular disorders. It is not clear if there is casual relationship between COVID and these disorders or just unmasked by the infection or subsequent immune process.