Delhi: Teen suffers paralysis, docs find Covid went undetected

New Delhi: Can Covid-19 cause sudden paralysis? This suspicion has been raised by doctors at Sir Ganga Ram Hospital (SGRH) who recently came across a 19-year-old boy with sudden paralysis of all four limbs.

The boy, a resident of west Delhi, didn’t have any history of chronic illness, but had a problem climbing the stairs one evening in the last week of August. By the next day, both his legs and hands were paralysed; he couldn’t walk even with support.

The family rushed him to the SGRH emergency where detailed investigations revealed that the boy had developed Guillain-Barré syndrome (GBS), a rare condition in which a person’s immune system attacks the peripheral nerves. However, tests also showed that the boy had antibodies against Covid-19, meaning he was affected by the viral infection too.

“We found antibodies against Covid-19 in the patient’s cerebrospinal fluid (CSF). It is possible that infection due to coronavirus triggered strong immune reactions leading to GBS,” said Dr Atul Gogia, senior consultant of internal medicine at SGRH.

He added that the boy had no fever on admission but he couldn’t breathe. Therefore, he had to remain on a ventilator for a few weeks. “We administered immunotherapy and kept him on mechanical ventilation to save his life. Once the condition improved, physiotherapy was done regularly,” the doctor said.

On Thursday, Dr Gogia added, the boy was discharged after spending nearly one and a half months in hospital. He can move his legs and lift his hands now. But there is no surety about how long it may take for the boy to be able to stand on his own.

“Our hospital has seen more than 3,000 Covid-19 cases till date. Most of them have severe symptoms. But this kind of complication is rare,” said another doctor.

The clinical characteristics of GBS are progressive weakness of the limbs and reduction in or loss of tendon reflexes. According to a study published in Neurological Sciences, GBS is usually caused by a viral or bacterial infection. “In response to the antigen, the immune system is activated and the nerve roots and peripheral nerves are injured because of the structural similarity of this antigen to axons and myelin. The symptoms peak within four weeks and the patients should be monitored because 20% to 30% of them will need mechanical ventilation,” the study states.

As of August 2020, several case reports of GBS have been published across the world in connection with Covid-19, suggesting a link between the viral infection and this rare condition.