Case presentation
A 54-year-old woman with a history of asthma was admitted to our hospital in May 2020 with reports of numbness and weakness in her extremities. Twenty days prior to the onset of neurological symptoms, she developed cough and fever; oropharyngeal reverse transcriptase PCR test results were positive for SARS-CoV-2. Although she had pneumonia on CT of the chest, oxygen was not needed. Therefore, we did not administer additional treatment, and continued budesonide, formoterol fumarate hydrate and montelukast sodium, that were originally being used to treat asthma. In addition, we used betamethasone only for the first 2 days to avoid the risk of exacerbation of asthma. Following approximately 2 weeks of treatment, PCR results were negative. However, at that time, she began to experience numbness in the lower extremities, that gradually spread to the upper extremities. Within the next week, she began to develop weakness in the extremities. Neurological examination revealed no findings suggestive of abnormalities in the central nervous system. Tendon reflexes in the upper extremities were normal, although they were absent in the lower extremities. The Medical Research Council Scale grade for muscle strength was 4/4 for proximal and 5/5 for distal muscles of the lower extremities, and 4/4 for proximal and 4/4 for distal muscles of the upper extremities; she was able to walk. Her modified Erasmus GBS Outcome Score (mEGOS) was 3/9, while her Hughes’ functional grade was 2. Superficial sensation was mildly impaired in the distal extremities, deep sensation was normal and she had no ataxia.