What symptoms suggest cytomegalovirus (CMV) infection in Guillain-Barre syndrome (GBS), and is coronavirus disease 2019 (COVID-19) associated with GBS?

Updated: Jun 24, 2020
  • Author: Michael T Andary, MD, MS; Chief Editor: Milton J Klein, DO, MBA  more...
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Answer

CMV infections present as upper respiratory tract infections, pneumonias, and nonspecific, flulike illnesses. GBS patients with preceding CMV infections often have prominent involvement of the sensory and cranial nerves. CMV infections are significantly associated with antibodies against the ganglioside GM2.

Evidence exists that coronavirus disease 2019 (COVID-19) is linked to the development of neurologic complications, including GBS. By April 20, 2020, one case of GBS in a patient with COVID-19 had been reported out of China and five such cases had been reported out of Italy. A report on the Italian cases said that GBS developed 5-10 days after COVID-19 had been diagnosed, with three of the patients having the demyelinating form of GBS, and the other two appearing to have an axonal variant. [29, 30, 31, 32]

In June 2020, the first US case report of a patient with GBS associated with COVID-19 was published. The syndrome developed soon after the individual became infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, with test results indicating that he had the demyelinating form of GBS. [33, 34]


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