47-year-old man with rare Guillain-Barre syndrome post-COVID treated at Delhi hospital, recovering

New Delhi, Nov 15: A 47-year-old man who had tested COVID-positive and later was diagnosed with Guillain-Barré syndrome, a rare condition in which the immune system attacks the nerves, has been successfully treated at a facility here, hospital authorities said on Saturday.

Guillain-Barre syndrome or GBS may be triggered by acute bacterial or viral infection in which the body loses its power to move. As GBS progresses, the muscles weaken which can evolve into paralysis if not detected early, they said.

"The 47-year-old COVID-positive patient, who has developed GBS after contracting the virus, was recently presented to the COVID-19 emergency ward in extreme respiratory distress," a spokesperson of the hospital said.

The team of doctors at Fortis hospital, Vasant Kunj, led by Gauri Shankar Sharma, head, critical care and Abhilekh Srivastava, consultant, neurology "determined that the condition was COVID-induced," the hospital claimed.

There is no known cure for GBS, but treatment can ease symptoms and reduce the duration of illness, doctors said.

A multi-disciplinary approach was adopted to treat the patient, consisting of doctors from critical care, neurology, gastroenterology, and endocrinology, the spokesperson said.

"His oxygen levels were in the range of 70-74 per cent, his sugar level very high, had ketones in urine and was in diabetic ketoacidosis. His COVID-19 rapid antigen test done in ER was positive.

In view of respiratory distress and difficulty in breathing, he required endotracheal intubation and mechanical ventilation," said Gauri Shankar Sharma, head, critical care at the facility. He underwent a series of investigations, including blood test and CT scan of chest. With treatment his condition improved, his sugar was corrected with insulin, and his acidosis resolved, the doctor said.

"On improvement of condition when his sedative medications were discontinued, it was noticed that he has muscle weakness which is making it difficult to get him out of ventilator, at this point of time neurological consultation was taken," Sharma said.

Abhilekh Srivastava, consultant neurology, said after examining the patient, it was found that he had weakness in all four limbs and the muscles of his face. "A provisional diagnosis of Guillain-Baare syndrome was made, based on clinical picture, which was subsequently confirmed, based on nerve conduction tests and a lumbar puncture examination. He was quickly started on treatment with intravenous immunoglobulins for five days," he said.

Towards the end of therapy, his requirement of a ventilator reduced significantly, and he was able to regain some mobility, though his cough reflex was bad, doctors said. He required per cutaneous tracheostomy for his weak cough reflex.

Post tracheostomy, he was completely weaned off from the ventilator and in a few weeks, he was able to sit in a wheelchair by himself, the hospital said.

"Two weeks after being discharged, his tracheostomy was removed, and he was able to breathe normally. He will take time to recover completely and will have to undergo regular physiotherapy," the spokesperson said.