COVID-19: The Rare but Scary Possibilities Part 2

Part 2: COVID-19 and Guillain Barre Syndrome

by Dr Makini McGuire-Brown

This is Part 2 of our COVID-19 Rare but Scary Possibilities. Last time we discussed the appearance of a Kawasaki-like illness in some children who have contracted this novel coronavirus; read more about that here. Today we will discuss Guillain Barre Syndrome which has been occurring in some adults who have had COVID-19.

In Part 1 we discussed a disease that causes wide spread inflammation of the blood vessels. In Guillain Barre there is wide spread inflammation of the nerves. Another similarity is that like Kawasaki disease, Guillain Barre often occurs after a viral illness; which COVID-19 is! There is some complacency out there about COVID-19 restrictions and some underestimation of the possibilities because many contract the virus and are mildly symptomatic or asymptomatic. Hopefully, the drama that is Guillain Barre Syndrome may spark some caution.

Guillain Barre causes progressive inflammation of the nerves. Now what is important to understand about nerves is that they provide the electrical impulses for our muscles to work. Therefore, dysfunction of the nerves causes weakening and/or temporary paralysis of the muscles.

Classic Guillain barre has a very dramatic presentation in which the patient loses muscle control from bottom to top. You may get numbness and tingling in your fingers then your arms get progressively weaker. The scariest part is that this isn’t only about your limbs. Remember that we use muscles to talk, swallow and breathe. As the disease progresses, patients develop slurred speech, difficulty swallowing and finally difficulty breathing, which lands you in ICU on a ventilator while you hope that treatment works so that you can breathe for yourself again. It’s a very scary experience for anyone who has ever experienced it or seen it. Being fully conscious but unable to control your own body is not an experience that anyone wants.

Guillain Barre is as unpredictable as it is scary. Some people have mild leg weakness and recover in a few weeks, others have complete paralysis of all 4 limbs, end up in ICU and after 18 months still don’t recover completely. There is no way of knowing which case you will be just as there is no way of knowing if you will be the person who develops Guillain Barre after having COVID-19.

It seems to me that following public health guidelines is a small precaution to take to prevent having an out of body experience. What do you think?  

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