PITTSBURGH (KDKA) — In the United States, the first documented coronavirus-related case was in a Pittsburgh hospital ⁠— a nerve problem called Guillain-Barre syndrome.

It typically happens after a viral illness, and the immune system response attacks the nerves.

“This results in progressive weakness, loss of sensations, and in some cases, progresses to the point where patients have trouble breathing,” says Dr. Sandeep Rana, a neurologist specializing in neuromuscular disorders at the Allegheny Health Network.

The patient was a 54-year-old contractor who started getting sick just after his wife was diagnosed with coronavirus.

“He was having difficulty breathing, he was running fevers,” Dr. Rana says.

He did have the infection with pneumonia and something else.

“While he was being treated for his COVID, (doctors) noticed he was getting weaker in his extremities,” says Dr. Rana. “The patient did have very characteristic features of Guillain-Barre syndrome.”

He was weak. When doctors tapped with a reflex hammer, no response. The spinal fluid and nerve tests were abnormal and showed he had Guillain-Barre syndrome. He ended up on a breathing machine.

“He had the dual problems of COVID infecting his lungs and the weakness of Guillain-Barre,” says Dr. Rana.

The doctors gave him the standard therapy for this — intravenous antibodies called IVIg.

He got off the ventilator, started rehab and gradually improved.

Usually, Guillain-Barre happens several weeks after an illness.

“This is something unique about COVID-19 that Guillain-Barre in COVID-19 tends to occur fairly rapidly,” said Dr. Rana.

In fact, the same pattern happened in a handful of patients in China, Italy and France.

So for the first American case to be documented in Pittsburgh, which has not been hard hit, doctors have some worries.

“We do feel that perhaps they are being under-diagnosed. (Cases) are out there,” Dr. Rana said.

Dr. Maria Simbra