TABLE 4.
GBS-related Data Among COVID-19–Related GBS Cases
| References | GBS Symptoms | ND | CN Involvement | AD Symptoms | Time | MRC and DTR | CSF | GBS Subtype | GBS Management | IVIG-D | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 17 | Paresthesia Tetraparesis Hypesthesia Areflexia | 3 | No | No | 4 | 3/5 UE 2/5 LE DTR absent global (S) | P: 54 mg/dL L: 9 cells/μL | NR | IVIG (0.40 g/kg/d for 5 d) | 3 | Deceased (severe respiratory failure) |
| 18 | Paresthesia Tetraparesis Areflexia | 9 (I) | Dysphagia | No | 11 | 2/5 PUE 4/5 DUE 2/5 LE DTR absent global (S) | P: 166 mgl/dL L: NR | AIDP | IVIG (0.40 g/kg/d for 5 d); LMWH | 3 | ICU admission and mechanically ventilated (respiratory insufficiency) |
| 19 | Paresthesia Quadriplegia Areflexia | 10 | No | No | 3 | NR | P: 100 mg/dL L: NR | AMSAN | IVIG (2 g/kg for 5 d) | 10 | No significant neurological improvement after 1 wk of treatment |
| 25 | FDP | 1 | FDP | No | 10 | NR Absent blink reflex bilaterally (S) | P: 44 mg/dL L: absent | FDP | Prednisone | NA | Small improvement of symptoms bilaterally after 2 wk |
| 26 | Lumbago Paresthesia Tetraparesis Areflexia | 10 | Dysphagia | No | 8 | 0/5 PUE 4/5 DUE 0/5 PLE 2-3/5 DLE DTR absent global (S) | P: NR L: NR | NR | None | NA | Deceased (severe respiratory failure) |
| 15 | Paraparesis Paraplegia Areflexia | 3 | Unilateral FNP | No | 10 | Initial 4/5 DUE(S) | P: 108 mg/dL L: absent | NR | IVIG (0.4 g/kg for 5 d) | 3 | Did not improve with treatment, progressively developed proximal weakness in all extremities, dysesthesia, and unilateral facial palsy |
| 16 | Paresthesia Tetraparesis Areflexia | 1 | No | No | 24 | 4/5 DUE 4/5 DLE DTR absent global (S) | P: 48 mg/dL L: 1 cell/L | NR | IVIG (400 mg/die for 5 d) | 3 | Worsening of muscle weakness causing respiratory failure |
| 4 | Paresthesia Paraparesis Areflexia | 10 | Dysphagia | No | 21 | 3/5 PLE 4/5 DLE DTR absent LE(S) | P: 140 g/L L: normal | AIDP | IVIG (0.40 g/kg/d for 5 d) | 12 | Almost complete recovery of neurological symptoms after the treatment |
| 14 | Tetraparesis FDP Areflexia | 5 | FDP | No | 9 | 2/5 PUE 3/5 DUE 1/5 PLE 2/5 DLE Grade 3 HB DTR absent global (S) | Not performed | AMSAN | IVIG (0.40 g/kg/d for 5 d) | 14 | NR |
| 27 | Tetraparesis Areflexia | 1 | No | No | 7(I) | 4/5 PUE 4/5 DUE 3/5 PLE 3/5 DLE DTR absent LE(S) | P: 124 mg/dL L: 5 cells/dL | AIDP | IVIG (dose NR) | 4 | Normal muscle strength in both UE and LE and return of DTR in LE |
| 27 | Paresthesia Tetraplegia Facial paresis Areflexia | 1 | Dysphagia Tongue weakness | No | 7 | NR | P: 101 mg/dL L: 4 cells/mm3 | AMSAN | IVIG (2 cycles; dose NR) | 2 | Persistence of severe UL weakness, LL paraplegia and dysphagia |
| 27 | Paresthesia FDP Ataxia Areflexia | <1 | FDP | No | 10 | NR | P: 123 mg/dL L: absent | AMSAN | IVIG (1 cycle; dose NR) | 1 | Decreased ataxia, disappearance of limb paresthesia, and mild decrease of facial weakness |
| 27 | Tetraparesis Facial paresis Respiratory failure Areflexia | 1 | FDP | No | 10 | NR | P: 193 mg/dL L: absent | AMAN | IVIG (2 cycles; dose NR) | 4 | Neuromuscular respiratory failure, progression to flaccid tetraplegia. His condition remained critical after 1 mo of neurological onset |
| 27 | Tetraparesis Ataxia Areflexia | 1 | No | No | 5 | NR | P: normal L: absent | AIDP | IVIG (1 cycle; dose NR) | 7 | Mild motor improvement after treatment, more evident in UE. However, patient unable to stand 1 mo after symptoms onset |
| 27 | Facial paresis Paraplegia Respiratory failure | 1 | Facial paresis Dysphagia | No | 7 | NR | P: 40 mg/dL L: 3 cells/mm3 | AIDP | IVIG (1 cycle; dose NR); plasmapheresis | 2 | Neuromuscular respiratory failure with concomitant Acinetobacter pneumonia during IVIG treatment. Patient still tetraplegic and ventilation dependent 4 wk after neurological onset |
| 28 | Paresthesia Ataxia | NR | No | No | NR | NR | P: 1928 mg/dL L: 2.6 cells/μL | AIDP | NR | NA | NR |
| 23 | Tetraparesis Hypoesthesia Facial paresis Dysphagia Areflexia | NR | Facial paresis Dysphagia | No | 10 | 3/5 PUE 3/5 PLE 4/5 DUE 4/5 DLE DTR absent global (S) | NR | NR | IVIG (dose NR) | NR | Worsening of motor function during the first 2 d of hospitalization, adding facial paresis and dysphagia to the previous symptoms. Slight improvement of neurologic and respiratory symptoms afterwards |
| 29 | Tetraparesis Areflexia | 2 | No | UR | 8 | 3/5 UE 2/5 LE DTR absent global (S) | Not performed | NR | IVIG (0.40 g/kg/d for 5 d) | 2 | Improvement of respiratory symptoms and UE weakness. LE weakness persisted after treatment |
| 20 | Paraparesis Allodynia Areflexia | 4 | No | UR Constipation | 10 | MRC NR DTR absent global (S) | Albumin-cytologic dissociation. Levels not reported | AIDP | IVIG (0.40 g/kg/d for 5 d) | 5 | Rapid improvement of neurological symptoms after treatment |
| 30 | Tetraparesis Areflexia FDP | NR | FDP | UR Resting tachycardia | 14 | 3/5 PUE 4/5 DLE 0-1/5 PLE 0-1/5 DLE(S) | Not performed | AIDP | IVIG (0.40 g/kg/d for 5 d) | NR | Improvement of respiratory symptoms. Worsening of neurological symptoms at follow up progressing to tetraparesis and FDP |
| 31 | Areflexia Paraparesis Decreased proprioception | 4 | No | No | 21 | NR | P: 1.65 g/L L: absent | NR | IVIG for 5 d (dose NR) | NR | NR |
| 32 | Areflexia FDP Dysarthria | NR | Yes | No | No COVID-19 symptoms at onset of neurological symptoms | NR | P: 1.00 g/L L: 4×106 cells/L | AIDP | IVIG (0.40 g/kg/d for 5 d) | 2 | The patient was discharged from hospital 2 d after completing IVIG. At that time, he had slight movements of his facial muscles, and the distal paresthesias of his lower extremities were unchanged |
| 33 | Paresthesias Quadriparesis FDP Dysphagia | 1 | Yes | No | 14 | 2/5 left UE 3/5 right UE 4/5 LE DTR absent global (S) | P: 0.86 g/L L: 3 cells/mm3 | AMSAN | IVIG (0.40 g/kg/d for 5 d) | NR | After 5 d of ICU admission, she was discharged to the neurology ward for clinical improvement with a motor balance of 5/5 (right arm), 3/5 (left arm), and 4/5 (both legs), with paresthesias persisting |
| 34 | Hyporeflexia Hypoesthesia Decreased proprioception | 7 | No | No | 10 | 4/5 UE 3/5 LE DTR absent LE(S) | NR | AIDP | IVIG (0.40 g/kg/d for 5 d) | 7 | On discharge patient could ambulate but with some residual weakness in lower extremities, so was referred for rehabilitation clinic |
| 35 | Hypoesthesia Dysesthesia Ataxia Paraparesis | 2 | No | No | 14 | 2/5 PUE 4/5 DUE 2/5 PLE 4/5 DLE DTR absent global (S) | P: 64 mg/dL L: 2 cells/mm3 | AIDP | IVIG 30g total dose for 1 d, followed by 4 cycles of plasma exchange | 3 | The patient improved gradually and was transferred to a neurorehabilitation facility 4 wk after symptom onset, where he regained mobility without significant help another 4 wk later |
| 36 | Dysarthria Hypogeusia Facial paresis Hypoesthesia Paraparesis | 1 | Yes | No | 16 | 4/5 PUE 4/5 PLE DTR absent global (S) | P: 46 mg/dL L: absent | Bifacial weakness with paresthesias (BFP) | 5 cycles plasma exchange | NR | Tolerated plasma exchange well with slight improvement in facial weakness and paresthesia. Discharged to inpatient rehabilitation |
| 37 | Ophthalmoparesis Ataxia Hyporeflexia Hypoesthesia | NR | Yes | No | 2 | NR | NR | MFS | IVIG (dose and duration NR) | NR | Subsequent improvement of neurological symptoms after IVIG treatment. Patient was discharged after 4 d of hospitalization |
| 38 | Quadriparesis Ataxia Paresthesia Dysgeusia Cacosmia | NR | No | Yes | 15 | NR | P: 60 mg/dL L: 3 cells/mm3 | AIDP | IVIG (0.40 g/kg/d for 5 d) | 2 | At 5 d, improvement of tetraparesis. Able to stand up with assistance |
| 38 | Tetraparesis Paresthesia Areflexia | NR | No | No | 7 | NR | P: 40 mg/dL L: 2 cells/mm3 | AIDP | IVIG (0.40 g/kg/d for 5 d) | 10 | At 5 d, dismissal with full motor recovery. Persistence of lower limb areflexia and distal paresthesia |
| 38 | Facial diplegia Paresthesia Paraparesis Dysphagia Areflexia | NR | Yes | Yes | 22 | NR | P: 140 mg/dL L: 4 cells/mm3 | AIDP | IVIG (0.40 g/kg/d for 5 d) | 2 | At 5 d, improvement of tetraparesis and ability to walk with assistance. Persistence of neuropathic pain and distal paresthesia |
| 39 | Diplopia Paraparesis Facial paresis Areflexia | 12 | Yes | Yes | 15 | 3/5 PLE 2/5 DLE DTR absent global (S) | P: 70 mg/dL L: 5 cells/mm3 | MFS | IVIG (0.40 g/kg/d for 5 d); gabapentin 900 mg/d | 13 | Progressive improvement in facial and limb paresis, diplopia and pain. Patient still on neurological rehabilitation |
| 40 | Paresthesia Quadriplegia Areflexia | 1 | No | Yes | 6 | 3/5 PUE 3/5 PLE DTR absent global (S) | P: 313 mg/dL L: 1 cell/mm3 | AIDP | IVIG (2 g/kg divided over 3 d) | 3 | Transferred to ICU and intubated. Developed ventilator-associated pneumonia (Stenotrophomonas maltophilia). Remains in the ICU with severe weakness |
| 41 | Quadriparesis Hypoesthesia | 1 | No | No | 6 | 4/5 UE 3/5 PLE 2/5 DLE DTR absent global (S) | P: 51 mg/dL L: normal cell counts | AIDP | IVIG (0.40 g/kg/d for 5 d) | 2 | Intubated and ventilated in the ICU. Treated for aspiration pneumonia. Oxygen requirements and inflammatory markers have improved; patient currently being weaned-off ventilation |
| 42 | Paresthesia Ataxia FNP | 4 | Yes | NR | 21 | 4/5 UE 3/5 DLE DTR absent global (S) | P: 0.94 g/L L: normal cell count | NR | IVIG started on day 5 (2 g/kg) | 5 | Discharged home with progressive improvement |
| 42 | Tetraparesis Dyspnea FNP | 3 | Yes | NR | 10 | 2/5 PLE 4/5 DLE DTR absent LE(S) | P: 1.06 g/L 6×106/L | NR | IVIG (2 g/kg) started day 4 of neurological symptoms | 4 | Condition improved slowly with physiotherapy, needing transfer to rehabilitation center |
| 43 | Dysphagia Facial paresis | NR | Yes | NR | 20 | NR | P: normal L: NR | GBS/MFS overlap syndrome | IVIG (0.4 g/kg/d for 5 d) | NR | Very rapid clinical response in swallowing, speech, tongue mobility and strength, and eyelid ptosis |
| 44 | Paraparesis | NR | NR | Paralytic ileus Loss of blood pressure control, | 23 | NR | P: normal L: NR | ASMAN | IVIG (0.4 g/kg/d for 5 d) | 3 | Autonomic symptomatology significantly improved—remission of gastroplegia and recovery of intestinal functions. Persistent osteotendinous hyporeflexia but slight improvement in foot drop |
| 45 | Hyposthenia Paresthesia Dysphagia Dysarthria FDP | NR | Yes | NR | 0 | 4/5 PUE 3/5 DUE 2/5 PLE 1/5 DLE DTR absent global (S) | P: 245 mg/dL L: 13/mm3 | NR | IVIG for 5 d | NR | Immediately after IVIG, improved to MRC scale of 4/5 in distal upper limbs and 3/5 in both proximal and distal lower limbs, FDP developed, ultimately transferred to rehabilitaiton care |
| 46 | Paraparesis Paresthesia FNP | 2 | Yes | NR | 18 | 4/5 UE 4/5 PLE 3/5 DLE DTR absent global (S) | P: 78 mg/dL L: 4/mm3 | NR | Did not receive treatment | NA | After 16 d of close monitoring, his muscle forces improved to near normal |
| 46 | Paraparesis Paresthesia | 4 | No | NR | 10 | 4/5 UE 2/5 PLE 3/5 DLE DTR absent at LE, decreased at UE(S) | NR | NR | IVIG (dose NR) | NR | Discharged after 14 d, muscle forces were 4/5 in all extremities |
| 47 | Paraparesis Paresthesia Facial paresis Dysphagia Dysarthria | 5 | Yes | NR | 18 | 4/5 PLE DTR absent at LE(S) | P: 226 mg/dL L: 3 cells/mm3 | NR | Plasmapheresis | NA | dysphagia has resolved and 28 d after GBS symptom onset, he can now ambulate with minimal assistance |
| 47 | Paraparesis Paresthesia Facial paresis Respiratory failure | 7 | Yes | NR | 23 | 3/5 PUE 4/5 PLE DTR absent at LE(S) | P: 67 mg/dL L: 1 cell/mm3 | NR | IVIG (dose NR); plasmapheresis | NR | Underwent tracheostomy and 25 d after GBS symptom onset, he remains quadriparetic with intermittent autonomic dysfunction, but is slowly being weaned from the ventilator |
| 48 | Tetraparesis Paresthesia FNP Dysphagia | 2 (I) | Yes | NR | 15 | 2/5 all extremities DTR absent global (S) | P: 0.86 g/L L: 3 cells/mm3 | NR | IVIG (2 g/kg/5 d) | NR | Started recovering by day 7 after the onset of weakness |
| 49 | FDP Paraparesis | 4 | Yes | NR | 28 | MRC NR DTR absent global (S) | P: normal L: normal | AMSAN | IVIG (2 g/kg/5 d) | 7 | Recovery started within days of treatment. On day 14 the patient was discharged with a mild proximal weakness in the lower extremities and FDP |
| 78 | Dysarthria Paraparesis | 3 | Yes | NR | (I)# NR | 4/5 LE DTR absent at LE(S) | P: 32.6 mg/dL L: normal | NR | Plasmapheresis | NA | Two weeks after the onset of symptoms, the neurological findings had improved markedly and she was able to walk without assistance |
| 51 | Tetraparesis Paresthesia FDP | 2 | Yes | NR | 14 | 2-4/5 all extremities DTR absent global (S) | P: normal L: 9 cell/μL | AIPD | IVIG (30 g daily for 5 d) | <1 | Thirty-one days after admission signs of motor improvement with regressive facial and hypoglossal paresis but still needed mechanical ventilation |
| 52 | Paresthesia Asthenia | NR | No | NR | 20 | 4/4 PLE 5/5 DLE 4/4 UE | NR | NR | Did not receive treatment | NA | Symptoms improved with discharge home on day 18 |
| 53 | Paresthesia Asthenia Lumbago Ascending quadriparesis | NR | No | No | 14 | 3/5 LE 4/5 UE | P: 117 mg/dL L: 2 cumm | NR | 2 mg/kg IVIG for 4 d | NR | Symptoms improved significantly, discharged to acute rehabilitation facility |
| 54 | Paresthesia Facial diplegia Asthenia | NR | Facial diplegia | None | 21 | 1/5 LE 3/5 PUE 2/5 DUE DTR absent global (S) | P: >1.25 g/L L: 1×106 cells/L | AIDP | IVIG 0.4 g/kg for 5 d | NR | Gradually improved, able to mobilize unassisted with neurorehabilitation and 15 wk after IVIG treatment |
| 55 | Paresthesia Dysautonomia | NR | No | UR | 3 mo | 4/5 LE DTR absent LE (S) | P: 127 mg/dL L: 8/cmm | NR | IVIG | NR | Motor and sensation largely returned at discharge |
| 56 | Paraplegia Urinary retention | NR | Esotropia, dysconjugate gaze | UR | NR | 3/5 UE 2/5 LE DTR absent global (S) | P: 620 mg/dL L: 1 cell/cumm | AIDP | IVIG 2 g/kg over 48 h | 2 | Extubated on hospital day 5, transferred to inpatient rehabilitation 3 wk after IVIG completion |
| 57 | Asthenia Paresthesia | 2 | Weak cough Dysphagia Dysarthria | Labile blood pressure Fecal retention | 13 | 5/5 UE 4/5 LE | P: 1.5 g/L L: absent | AIDP | IVIG 0.4 g/kg | NR | Extubated on hospital day 18, discharged to community rehabilitation unit, then to home |
| 58 | Asthenia Areflexia Paresthesia | 1 | NR | NR | 4 | 3/5 PUE 2/5 DUE 3/5 LE DTR absent global (S) | P: 1.14 g/L L: <1/mm3 | AMSAN | IVIG 0.4 g/kg/d for 5 d | NR | Discharged on hospital day 12, significant improvement with residual weakness in hands and feet |
| 59 | Tetraparesis | NR | Facial paresis | NR | 18 | MRC: NR DTR absent global (S) | P: 52 mg/dL L: 1 cell/mm3 | NR | IVIG cycle (0.4 g/kg for 5 d) | NR | Progressive improvement of tetraparesis after initiating IVIG therapy |
| 59 | Tetraparesis | NR | None | NR | 30 | MRC: NR DTR absent global (S) | P: 40 mg/dL L: 1 cell/mm3 | NR | IVIG cycle (0.4 g/kg for 5 d) | NR | Progressive improvement of asthenia after initiating IVIG therapy |
| 59 | Ophthalmoplegia Ataxia | NR | Ophthalmoplegia Facial hypoesthesia | NR | 14 | MRC: NR DTR absent global (S) | P: 72 mg/dL L: 5 cell/mm3 | NR | IVIG cycle (0.4 g/kg for 5 d) | NR | Progressive improvement of neurological symptoms after initiating IVIG therapy |
| 59 | Lower extremity Asthenia | NR | None | NR | 33 | MRC: NR DTR diminished global (S) | Not performed | NR | Methylprednisolone 60 mg for 5 d | NR | Stationary; no significant improvement of neurological symptoms after initiating IVIG therapy |
| 59 | Asthenia Facial paresis Diplopia | NR | Facial paresis Diplopia | NR | 22 | MRC: NR DTR absent global (S) | P: 53 mg/dL L: 2 cell/mm3 | NR | IVIG cycle (0.4 g/kg for 5 d) | NR | Progressive improvement of neurological symptoms after initiating IVIG therapy |
| 60 | Dysphagia Asthenia Paresthesias Facial diplegia Dysphagia Dysarthria | 2 | Facial diplegia and paresthesias Dysphagia Dysarthria | NR | 1 | 4/5 UE 3/5 PLE DTR: +1 throughout | P: 74 mg/dL L: absent | Recurrent GBS secondary to COVID-19 infection or CIDP | IVIG cycle (0.4 g/kg for 5 d) | 3 | Residual asthenia and hypoxia resolved weeks after discharge; regained full muscle strength but severe persistent paresthesias of the medial left knee up to the medial thigh |
| 61 | Hypoesthesia Paraparesis | 1 | None | NR | 5 | 2/5 left UE 3/5 right DUE DTR absent global (S) | P: 52 mg/dL L: absent | ADP | IVIG cycle (0.4 g/kg for 5 d) | NR | Discharged from ICU 14 d after intubation with residual severe flaccid tetraparesis, bilateral facial palsy, and dysphagia; underwent 7 wk of rehabilitation and now able to walk independently with support |
| 62 | Quadriparesis Facial paresis Asthenia | 5 | NR | NR | 7 | 1/5 LE 2/5 UE DTR absent global (S) | NR | NR | IVIG cycle (0.4 g/kg for 5 d) | NR | Respiratory and neurological status improved 5 d after admission after course of IVIG; planned for weaning and extubation on day 6 but patient unintentionally self-extubated and expired from cardiac arrest |
| 63 | Paresthesias Asthenia Respiratory failure | NR | NR | Loss of blood pressure and heart rate control Fecal incontinence Urinary retention | 22 | 2/5 LE 3/5 UE 3/5 neck flexion and extension DTR: absent in LE, diminished in UE | P: 197 mg/dL L: absent | NR | IVIG cycle (0.4 g/kg for 5 d), enoxaparin 30 mg bid | NR | Improvement in respiratory and neurological function; ambulating with assistance 2 mo after admission; persistent neuropathic pain in lower extremities |
| 64 | Paresthesias Asthenia Gait disturbance | 13 | No | No | 18 | 3/5 right DLE 4/5 left DLE 4/5 DUE DTR: diminished global (S) | P: normal L: normal | AMSAN | IVIG cycle (0.4 g/kg for 5 d) | 16 | After IVIG, significant improvement in asthenia but persistent gait disturbance; patient transferred to rehabilitation and slowly regained ability to walk unassisted after 1 mo at discharge |
| 65 | NR | NR | NR | NR | NR | NR | NR | AIDP | IVIG | NR | NR |
| 65 | NR | NR | NR | NR | 0 | NR | P: 0.6 g/L L: NR | Classical GBS | IVIG | NR | NR |
| 65 | NR | NR | Yes | NR | 20 | NR | P: 0.3 g/L L: NR | NFS-GBS Overlap | IVIG | NR | NR |
| 65 | NR | NR | NR | NR | 3 | NR | P: 1 g/L L: NR | Classical GBS | IVIG | NR | NR |
| 65 | NR | NR | NR | NR | 20 | NR | P: 0.2 g/L L: NR | AMSAN | IVIG | NR | NR |
| 65 | NR | NR | NR | NR | 15 | NR | P: 0.9 g/L L: NR | AMSAN | IVIG | NR | NR |
| 66 | Ataxia Asthenia Paresthesias Dysphagia Quadriparesis Respiratory failure | NR | Bilateral ptosis, CN 3,4,6 deficits Dysphagia | NR | 14 | 2/5 right UE, LE 0/5 left UE DTR absent global (S) | P: normal L: normal | MFS-GBS overlap | IVIG cycle (0.4 g/kg for 5 d) | 4 | 5 wk after admission, transferred to LTAC for vent weaning and PT, now 5.5 postdiagnosis and tolerating few hours per day of pressure support; patient able to control head, some distal extremity, extraocular, and tongue movements |
| 79 | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | |
| 67 | FDP Pharyngeal paralysis Dysphagia Quadriparesis | 4 | FDP Pharyngeal paralysis Dysphagia | Urinary incontinence | 5 to 10 | 2/5 PLE 1/5 DLE 3/5 UE DTR diminished global (S) | P: 64 mg/dL L: normal | AIDP | IVIG cycle (0.4 g/kg for 5 d) | NR | Marked neurological improvement on hospital day 16 with residual urinary incontinence; patient transferred to physiotherapy unit for rehabilitation |
| 68 | Paresthesia Tetraparesis | 1 | No | UR | 5 | 3/5 UE 3/5 LE DTR absent global (S) | P: 222 mg/dL L: 0 cells/μL | NR | 5 cycles plasma exchange | NA | Hospitalization subsequently complicated by streptococcal bacteremia requiring antibiotics. Discharged at day 30 with improved neurological condition |
| 69 | Paraparesis | 26 (I) | NR | No | 31 | 3/5 LE DTR absent LE (S) | P: 48 mg/dL L: 0 cells/μL | AMSAN | IVIG (dose NR) | 5 | Deceased due to ARDS |
| 70 | Paraparesis | NR | NR | UR Loss of blood pressure control | 20 | MRC NR DTR absent global (S) | P: normal range L: NR | AMSAN | IVIG (0.4 g/kg/d) | NR | After 5 d, the vegetative symptomatology significantly improved, with the remission of gastroplegia and recovery of intestinal functions |
| 70 | Ptosis Dysphagia Dysphonia | 20 (I) | Yes | No | 20 | 5/5 both UE and LE DTR decreased (S) | P: normal L: NR | MFS | IVIG (0.4 g/kg/d) 5 d | NR | The first clinical improvements occurred during the fifth day of treatment, with progressively improving trend and complete remission on swallowing and feeding |
| 71 | Tetraparesis | 1 | NR | No | <1 | 2/5 both UE and LE DTR decreased global (S) | P: 39 mg/dL L: 1 cell/μL | AIPD | IVIG (0.4 g/kg/d) 5 d | NR | Patient was extubated on the 17th day of illness. Subsequently, he was discharged from the hospital 24th day of illness with no residual muscle weakness |
| 72 | FDP Dysarthria Dysphagia | <1 | Yes | No | 7 | 5/5 both UE and LE | P: 77 mg/dL L: NR | AIPD | IVIG (0.4 g/kg/d)5 d | NR | Progressive clinical improvement was observed after 2nd dose of IVIG, leading to discharge |
| 73 | Paraparesis | 27 (I) | Yes | Hypertensive crisis Tachyarrhythmia-bradyarrythmia | 36 | 3/5 UE 4/5 LE DTR decreased global (S) | P: 48 mg/dL L: 0 cells/μL | AIPD | Supportive | NA | Forty days from fever the patient showed a spontaneous improvement of the clinical picture, at day 56 after admission only mild weakness of the deltoid bilaterally and left biceps was evident |
| 74 | Tetraplegia Paresthesis FDP | <1 | Yes | No | 10 | Initial MRC NR DTR absent global (S) | P: 1 g/dL L: 0 cells/μL | NR | IVIG (0.4 g/kg/d) 5 d Plasma exchange (4 cycles) | NR | Following IVIG and steroids, a partial clinical improvement was seen. Two months after onset, FDP was still severe but improvements in muscle strength continued in axial, proximal and distal segments |
| 75 | Paraparesis | 3 | No | No | 21 | 5/5 UE 3/5 LE DTR absent at LE (S) | P: 20 mg/dL L: 0 cells/μL | NR | IVIG (0.4 g/kg/d) 5 d | NR | After 1 wk of hospitalization, her strength began to improve. She was eventually discharged home after 10 d in the hospital. A follow-up phone call after 3 wk, found that that patient was already ambulating short distances with minor help |
| 76 | Tetraparesis | 3 | No | No | 10 | 4/5 UE 2/5 LE DTR absent global (S) | P: 54 mg/dL L: 5 cells/μL | AMAN | IVIG (0.4 g/kg/d) 5 d | NR | Patient was discharged after 10 d of hospital stay with grade 4/5 power in both lower limbs and grade 4+/5 power in both upper limbs |
| 76 | Tetraparesis | 3 | No | No | 6 | 3/5 UE 2/5 LE DTR absent global (S) | P: 74 mg/dL L: 0 cells/μL | AMSAN | IVIG (0.4 g/kg/d) 5 d | NR | Worsening respiratory distress, patient expired after 7 d of hospitalization |
| 76 | Tetraparesis | 3 | No | No | 7 | 4/5 UE 3/5 LE DTR absent at LE (S) | P: 84 mg/dL L: 5 cells/dL | AMSAN | IVIG (0.4 g/kg/d) 5 d | NR | Good improvement (able to walk independently at discharge) |
| 76 | FNP Paraparesis | 4 | Yes | No | 10 | 5/5 UE 3/5 LE DTR absent at LE | P: 52 mg/dL L: 5 cells/dL | AMAN | IVIG (0.4 g/kg/d) 5 d | NR | Good improvement (able to walk independently at discharge) |
| 77 | Paraparesis Parestesis | 7 | No | No | 53 | 5/5 UE 3/5 LE DTR absent at LE | P: 127 mg/dL L: <2 cells/dL | AIDP | IVIG (0.4 g/kg/d) 5 d | NR | Three months after his hospital discharge, he has been able to walk independently, occasionally using a stick for longer distances |
AAA indicates abdominal aortic aneurysm; AD, autonomic dysregulation; AIDP, acute inflammatory demyelinating polyradiculoneuropathy; AMAN, acute motor axonal neuropathy; AMSAN, acute motor-sensory axonal neuropathy; ARDS, acute respiratory distress syndrome; CN, cranial nerve; COVID-19, Coronavirus Disease 19; CSF, cerebrospinal fluid; DLE, distal lower extremities; DTR, deep tendon reflexes; DUE, distal upper extremities; FDP, facial diplegia; FNP, facial nerve palsy; GBS, Guillain-Barré syndrome; HB, House-Brackmann Facial Paralysis Scale; (I), symptoms started inversely; ICU, intensive care unit; IVIG, intravenous immunoglobulin; IVIG-D, days between neurological symptom’s onset and the start of IVIG treatment; L, leukocytes; LE, lower extremities; LMWH, low–molecular-weight heparin; LTAC, Long-term acute care; MFS, Miller-Fisher syndrome; MRC, Medical Research Council Scale for Muscle Strength; NA, not applicable; ND, days between neurological symptoms and hospital admission; NR, not reported; P, protein; PLE, proximal lower extremities; PT, physical therapy; PUE, proximal upper extremities; (S), symmetric; Time, days between the onset of COVID-19 symptoms and onset of neurological symptoms; UE, upper extremities; UR, urinary retention.