Four patients had facial diplegia at time of follow-up (4.26%). A comparison of the clinical features of patients presenting with AIDP to other variants is shown in Table 5. shown in Table 3 . The patients’ mean age was 56??16?years, and most of the patients were male (61/94, 64.89%). Co-morbid conditions, particularly malignancy, chronic lung diseases such as chronic obstructive pulmonary disease (COPD), chronic vascular disease (dyslipidemia and peripheral artery disease), metabolic disease (obesity and type 2 diabetes mellitus), and heart disease (coronary heart disease and hypertension) were present in 28 patients (28/94, 29.78%) (Table 3). Many patients had presented with other co-morbid conditions such as dyslipidemia (6/94, 6.38%), cancer (4/94, 4.26%), obesity (3/94, 3.19%), coronary artery disease (2/94, 2.13%), and COPD (2/94, 2.13%) and peripheral artery disease (1/94, 1.06%). The most common time from symptom onset to the clinical presentation was 0 to 10?days (34/94, 36.17%) (Table 3). Table 3 Baseline characteristics of Fructose 94 patients.
Age in years (mean??SD)56??16Gender?Male (n, %)61 Fructose (64.89)Co-morbid conditions?Hypertension16 (17.02)?Type 2 DNMT3A diabetes mellitus10 (10.60)?Othersa18 (19.15)Time from onset of COVID symptoms to neurological symptoms?0C10?days34 (36.17)?11C20?days29 (30.85)?21?days or more25 (26.59)Status of RT-PCR COVID sample?Nasopharyngeal sample positive65 (69.15)?Oropharyngeal sample positive16 (17.00)?Serology (COVID-19 antibodies) positive5 (5.30)?Presented to facility with diagnosed COVID-198(8.51)Symptoms?Fever62 (65.95)?Respiratory symptoms68 (72.34)?GI symptoms18 (19.15)?Paresthesia46 (48.93)?Paresis of lower and upper extremity60 (63.83)Findings on examination (n?=?64)?Reduced power in upper/lower extremities47 (73.43)?Areflexia42 (65.63)?Diminished sensation23 (35.94)?Ataxia07 (10.94)?Hyperreflexia01 (1.56) Open in a separate window aOther co-morbid conditions include obesity, COPD, cancer, peripheral artery disease, dyslipidemia, and coronary artery disease. 3.1. Clinical symptoms and COVID-19 status All 94 patients were presented with both non-neurological and neurological findings. The neurological presentation was preceded by respiratory symptoms in 68 patients (72.35%) while gastrointestinal symptoms in 18 patients (19.15%). There was a significant overlap of presenting symptoms. Among the neurological findings, paresthesia was the commonest symptom (46/94, 48.93%) followed by paresis of the lower extremity (39/94, 41.49%) and upper extremity (21/94, 22.34%). Bulbar symptoms were present in 20/94 patients (21.28%), ataxia and gait disturbance were present in 21/94 patients (22.34%) whereas 11/94 patients (11.70%) reported vision symptoms including eyelid ptosis (2/11; 18.18%), diplopia (6/11; 54.55%), retroorbital pain (1/11; 9.09%) and ophthalmoplegia (2/11; 18.18%). Apart from the patients who had COVID-19 diagnosed at the facility where the cases were reported (Table 3), most of the patients had Fructose been transferred or had been already diagnosed with COVID-19 at a prior facility before the presentation (8/94, 8.51%). Majority of the patients had positive COVID-19 result through RT-PCR from a nasopharyngeal sample (65/94, 69.15%). 3.2. Neurological examination relevant to GBS spectrum The clinical features were variable. The most common exam obtaining was reduced power (73.43%) in either the upper or lower extremities. It was symmetrical in some cases but was also asymmetric in some patients. Patients also had reduced sensations to pinprick, vibratory or proprioceptive stimuli. One patient had Fructose hyperreflexia, rather than areflexia which Fructose was noticed in most cases (65.63%). 3.3. Results of electrophysiological, CSF, and neuroimaging investigations Electromyography/electroneurography results were available for 70/94 patients (74.47%). The most common obtaining was demyelination in 44/70 patients (62.86%) followed by associated sural sparing with demyelination in 7/70 patients (10.00%), mixed demyelination and axonal damage in 5/70 patients (7.14%), axonal motor and sensory changes in 3/70 patients (4.28%). (Table 4 ). Table 4 Clinical characteristics of 94 patients.
Abnormal CT imaging (chest)35 (37.23)Abnormal MRI (brain and/or spine)16 (17.02)Electromyography (EMG) (n?=?70)?Demyelination44 (62.86)?Axonal motor and sensory with muscle/neurogenic damage1 (1.43)?Demyelination with sural sparing7 (10.00)?Axonal motor and sensory changes3 (4.29)?Axonal changes2 (2.86)?Mixed demyelination and axonal damage5 (7.14)?Absent blink reflex1 (1.43)?Mixed demyelination with sural damage1 (1.43)?Demyelination with absent blink reflex1 (1.43)?Axonal changes and sural sparing1 (1.43)?Axonal motor, sensory changes and sural sparing1 (1.43)?Axonal motor changes3 (4.29)Findings on CSF analysis (n?=?80)?CSF proteins elevated70/80 (87.50)?CSF glucose levels elevated19/80 (23.75)?CSF WBC count normal54/80 (67.50)?Presence of oligobands in CSF3/80 (3.75)?Presence of anti-ganglioside antibodies in CSF,2/80 (2.50)?Mode of treatment?Floor50 (53.20)?ICU8 (8.50)?Transferred to ICU27 (28.70)?Transferred to floor from ICU9 (9.60)Treatment received?Immunoglobulins73 (77.66)?Steroids15 (15.96)?Plasmapharesis11 (11.70)?Hydroxychloroquine27 (28.70)?Antibiotics16 (17.02)?Antivirals21 (22.34)Oxygen requirements?Invasive33 (35.11)?Non-invasive61 (64.89)?Mortality5 (5.30)Complications?Respiratory insufficiency23 (24.47)?Bulbar symptoms12 (12.77)?Autonomic dysfunction8.