Table 2.

Characteristics of patients with GBS related to COVID-19 infection

Patient no.	GBS symptoms	Nerve studies
1 [30]	• Paresthesia in feet and hands	• A flaccid severe tetraparesia • Medical Research Council (MRC) strength evaluation was 2/5 in the legs, 2/5 the arms, 3/5 in the forearms and 4/5 in the hands • Tendon reflexes were abolished in the four limbs • Swallowing disturbance
2 [31]	• Asthenia, and myalgia in legs • Paraesthesia, hypoesthesia, and distal weakness in the lower limbs • Midthigh and tip of the fingers associated with ataxia • Right peripheral facial palsy	• Decreased light touch from midthigh to feet and the tip of the fingers • Decreased vibration sense in the lower limbs • Symmetric weakness for dorsiflexion • Extension of the toes (MRC score = 3/5) and flexion of the thigh (MRC = 4/5) • Areflexia in the forelimbs apart from the left biceps reflex
3 [31]	• acute proximal tetraparesis and distal forelimb and perioral paraesthesia.	• proximal lower limb weakness (MRC 2/5), distal weakness (MRC 4/5), and diffuse areflexia • A typical demyelinating pattern with a conduction block in the left median nerve • temporal dispersion, upper limb increased motor distal latencies • Diffuse decreased motor and sensory conduction velocities • Lower than 38 m/s in 9 nerves of 10 tested, and neurogenic pattern on EMG • Left peripheral facial palsy
4 [32]	• Symmetric weakness in lower limbs, leading to falls and paraplegia	• Weakness in the upper limbs (MRC 4/5) and diffuse areflexia, but no clear sensory deficits • F-waves with diffuse prolonged distal motor latencies and reduced distal compound muscle action potential amplitudes with a slight reduction of conduction velocities, thus suggesting a mixed pattern of demyelination and axonal damage • No sensory nerve action potential was registered
5 [33]	• Paresthesia at limb extremities • Distal weakness rapidly evolving to a severe • Flaccid tetraparesis	• Symmetric limb weakness (MRC score 3/5 at upper limbs and 2/5 at lower limbs) • Hypoesthesia at the 4 limbs • Absent deep tendon reflexes • Severe paresthesia in both hands and feet • Absence of both the sural nerve sensory nerve action potential (SAP) and the tibial nerve compound muscle action potential (CMAP)
6 [34]	• Asthenia and paresthesia at feet and hands • Gait difficulties	• Symmetric distal upper and lower limbs weakness • Loss of deep tendon reflexes • Preserved light touch and pinprick sensation
7 [35]	• Bilateral lower limb pain • Irritability • Difficulty walking • Loss of balance • Unilateral peripheral facial and bulbar palsy	• Left facial droop • Effacement of left nasolabial fold while smiling • Inability to close the left eye • Raise the left eyebrow or frown • All consistent with Bell’s palsy • The position sensation was decreased • Deep tendon reflexes were absent • Dysmetria and appendicular ataxia were present in all four limbs
8 [36]	• Weakness in both legs and severe fatigue	• Symmetric weakness (MRC grade 4/5) • Areflexia in both legs and feet • Sensation to light touch and pinprick was decreased distally
9 [37]	• Numbness and weakness of his lower extremities	• (MRC: 2/5 strength in his lower extremities with 3/5 in his upper extremities) • Absence of deep tendon reflexes • Ascending paralysis with supporting physical exam findings
10 [38]	• Gait disturbance • Weakness in hip flexors • Paresthesias of his hands and feet	• Proprioceptive sense at the toes • Bilateral facial weakness • Dysphagia • Dysarthria • Neck flexion weakness and inability to ambulate
11 [38]	• Paresthesia of his hands and feet • Gait disturbance	• Initial examination revealed 3/5 shoulder shrug, 4−/5 hip and neck flexion • Diminished vibration and proprioception at the toes • Reflexes were 1+ in the arms and absent in the legs • Unable to stand or ambulate independently
12 [39]	• Bilateral weakness and tingling • Sensation in all four extremities	• quadriplegia, hypotonia, areflexia, and bilateral positive Lasègue sign • reduction or absence of electrical potentials in both motor and sensory nerves in all four limbs
13 [40]	• Bilateral facial nerve palsy	• No other neurological findings at examination
14 [41]	• Paraparesis • Distal allodynia • Difficulties in voiding and constipation	• Bilateral lower limb flaccid paresis • Absent deep tendon reflexes of the upper and lower limb • Idiomuscular response to percussion of the muscle tibialis anterior • Indifferent plantar reflexes • No sensory deficit
15 [42]	• Pain and numbness in distal lower and upper • Extremities progressive weakness in legs	• A mild peripheral facial • Nerve palsy on the right side • Muscles’ forces were 4/5 in distal and proximal lower extremities according to the MRC grading • The upper extremities showed no weakness • Deep tendon reflexes were absent in all four limbs • Demyelinating polyneuropathy
16 [42]	• Ascending lower and upper • Extremities weakness • Paresthesia	• Decreased forces, MRC grade of 2/5 at proximal and 3/5 at distal lower limbs, and 4/5 in both arms • Deep tendon reflexes were absent in both legs and decreased to 1+ in the upper extremities
17 [43]	• Symmetric paresthesias • Ascending appendicular weakness	• Mental status and cranial nerves were normal • Strength was 4/5 neck flexion, 3/5 proximal upper and lower extremities bilaterally • Tendon reflexes were absent • Sensation to light touch was diminished to wrists and • knees bilaterally
18 [44]	• Symmetric ascending quadriparesis	• weakness in four limbs with a MRC scale of 2/5 in proximal, 3/5 in distal of the upper extremities and 1/5 in proximal, 2/5 in distal of the lower extremities • Deep tendon reflexes were absent • Reduction in the vibration and fine touch sensation distal to the ankle joints and also bifacial nerve palsy • No spine sensory level • AMSAN form
19 [45]	• Unsteadiness and paraesthesia in both hands • Bilateral facial nerve palsy, oropharyngeal weakness, and severe proximal tetraparesis	• Mild proximal tetraparesis 4/5 on the Medical Research Council (MRC) scale with global areflexia • Touch, pinprick and proprioception were normal
20 [46]	• Root-type pain in all four limbs • Weakness in his lower limbs • Inferior bilateral facial paresis • Paraparesis	• Left external rectus muscle with horizontal diplopia • Global areflexia • Acute demyelinating polyneuropathy • Denervation • Paresis of the left external rectus muscle with horizontal diplopia when looking to the left
21 [47]	• Perioral paresthesias, but no facial weakness • Ataxic gait	• Flexor bilaterally • Neuro-ophthalmologic examination revealed visual acuity of 20/b25 in both eyes • Right internuclear ophthalmoparesis and right fascicular oculomotor palsy
22 [47]	• Acute onset of diplopia	• Visual acuity of 20/25 in both eyes • Severe abduction deficits in both eyes, and fixation nystagmus, with the upper gaze more impaired, all consistent with bilateral abducens palsy • Deep tendon reflexes were absent
23 [48]	• Proximally pronounced • Moderate symmetric paraparesis	• Progressive proximally pronounced paraparesis, areflexia, and sensory loss with tingling of all extremities
24 [49]	• Inferior bilateral facial paresis • Paraparesis	• Arreflexia
25 [50]	• Progressive weakness • Numbness of the lower extremities	• Mild dysarthria due to jaw weakness and bilateral, predominantly lower limb weakness, with 4−/5 strengths in knee and ankle flexor and extensor muscles, and 4−/5 in the left and 4+/5 in right hip flexor muscles by the Medical Research Council (MRC) scale • Tendon reflexes were absent
26 [51]		• Flaccid areflexic tetraplegia evolving to facial weakness, upper limb paresthesia and respiratory failure
27 [51]		• Facial diplegia and generalized areflexia evolving to lower limb paresthesia with ataxia
28 [51]		• Flaccid tetraparesis and facial weakness evolving to areflexia and respiratory failure
29 [51]		• Flaccid areflexic tetraparesis and ataxia
30 [51]		• Facial weakness, flaccid areflexic paraplegia, and respiratory failure
31 [52]	• Acute progressive paresthesia of distal lower extremities evolving to the upper limbs leading to quardiparesthesia	• Facial paralysis and mildly dysarthric speech • Deep tendon reflexes were generally absent • Acute demyelinating polyneuropathy