Table 1. Characteristics of Five Patients with Guillain–Barré Syndrome after the Onset of Covid-19.^*.

Patient No.	Onset of Neurologic Syndrome	Neurologic Signsand Symptoms	CSF Findings†	Antiganglioside Antibodies‡	MRI Results	Treatment and Outcomesat Week 4
1	7 Days after fever, cough, and ageusia	Flaccid areflexic tetraplegia evolving to facial weakness, upper-limb paresthesia (36 hr), and respiratory failure (day 6)	Day 2 (first lumbar puncture): normal protein level; no cells; negative PCR assay for SARS-CoV-2 Day 10 (second lumbar puncture): protein level, 101 mg/dl; white-cell count, 4 per mm3; negative PCR assay for SARS-CoV-2	Negative	Head: normal Spine: enhancement of caudal nerve roots	Received 2 cycles of IVIG; had poor outcomes, including persistence of severe upper-limb weakness, dysphagia, and lower-limb paraplegia
2	10 Days after fever and pharyngitis	Facial diplegia and generalized areflexia evolving to lower-limb paresthesia with ataxia (day 2)	Day 3: protein level, 123 mg/dl; no cells; negative PCR assay for SARS-CoV-2	Not tested	Head: enhancement of facial nerve bilaterally Spine: normal	Received IVIG; had improvements, including decrease in ataxia and mild decrease in facial weakness
3	10 Days after fever and cough	Flaccid tetraparesis and facial weakness evolving to areflexia (day 2) and respiratory failure (day 5)	Day 3: protein level, 193 mg/dl; no cells; negative PCR assay for SARS-CoV-2	Negative	Head: normal Spine: enhancement of caudal nerve roots	Received 2 cycles of IVIG; had poor outcomes, including ICU admission owing to neuromuscular respiratory failure and flaccid tetraplegia
4	5 Days after cough and hyposmia	Flaccid areflexic tetraparesis and ataxia (day 4)	Day 5: normal protein level; no cells; negative PCR assay for SARS-CoV-2	Not tested	Head: normal Spine: normal	Received IVIG; had mild improvement but unable to stand 1 mo after onset
5	7 Days after cough, ageusia, and anosmia	Facial weakness, flaccid areflexic paraplegia (days 2–3), and respiratory failure (day 4)	Day 3: protein level, 40 mg/dl; white-cell count, 3 per mm3; CSF:serum albumin ratio, 1.2%; negative PCR assay for SARS-CoV-2	Negative	Head: not performed Spine: normal	Received IVIG and plasma exchange; had bacterial pneumonia during IVIG treatment, which delayed plasma exchange

^*Covid-19 denotes coronavirus disease 2019, CSF cerebrospinal fluid, ICU intensive care unit, IVIG intravenous immune globulin, MRI magnetic resonance imaging, PCR polymerase chain reaction, and SARS-CoV-2 severe acute respiratory syndrome coronavirus 2.

^†On CSF analysis, all the patients had a normal glucose level and IgG index and a polyclonal pattern on electrophoresis. The normal range for the protein level is 15 to 45 mg per deciliter.

^‡An enzyme-linked immunosorbent assay was used to test for antibodies to GM1, GQ1b, and GD1b.