COVID-19 and Neonatal Guillain-Barré Syndrome: Exploring a Possible Causal Link With Review of Literature

Abstract

Introduction

Guillain-Barré Syndrome (GBS) is an immune-mediated polyneuropathy that is rare in neonates. It may be acquired congenitally via maternal antibody transfer or postnatally after infection. We report a case of postnatally acquired neonatal GBS potentially triggered by SARS-CoV-2 with a review of the literature.

Patient

A 24-day-old term male presented with progressive hypotonia, a weak cry, and respiratory distress. He had a preceding febrile illness with gastrointestinal symptoms. Examination revealed areflexia, cranial nerve involvement, and generalised weakness.

Results

Investigations showed albuminocytologic dissociation in cerebrospinal fluid, cauda equina enhancement on magnetic resonance imaging, and motor-sensory polyneuropathy on nerve conduction studies. The infant had high anti-SARS-CoV-2 IgG (>4000 IU/mL) with negative maternal titres. After 2 courses of intravenous immunoglobulin (IVIg), he recovered fully and remained developmentally normal at 2-year follow-up.

Conclusion

GBS should be considered in floppy neonates with a postinfectious presentation. This case highlights the possibility of SARS-CoV-2 as a postnatal trigger and the importance of early recognition and treatment with IVIg.