The 32-year-old midfielder was forced off in the first half of June’s Champions League final triumph against Inter Milan and did not play a single minute of pre-season.
De Bruyne returned as a second-half substitute in the Community Shield shoot-out loss to Arsenal and captained the side against Burnley in Friday’s Premier League opener.
But the Belgium playmaker only lasted 23 minutes at Turf Moor, where seemingly out of nothing he signalled to the bench that he had felt something.
Guardiola said the issue related to the same hamstring and would see him miss “a few months”, but it is worse than first feared and a decision has to be made over surgery.
“It’s a seriously injury,” the City boss said. “We have to decide surgery or not surgery but a few months out.”
The decision on surgery will be taken in the coming days and could see him miss “three or four months”, Guardiola said.
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