tetano
Editor, Senior Moderator
eNeurologicalSci
. 2021 Sep;24:100355.
doi: 10.1016/j.ensci.2021.100355. Epub 2021 Jul 9.
Pediatrics COVID-19 and neurological manifestations: Single tertiary centre experience
Lama Aljomah[SUP] 1 [/SUP], Sara Almedlej[SUP] 1 [/SUP], Duaa Baarmah[SUP] 1 2 [/SUP], Waleed Altwaijri[SUP] 1 2 [/SUP], Ahmad Alrumayyan[SUP] 1 2 [/SUP], Muhammad Talal Alrifai[SUP] 1 2 [/SUP], Mohammed Almuqbil[SUP] 1 2 3 [/SUP], Mohammad Alshalaan[SUP] 1 2 [/SUP]
Affiliations
Abstract
Importance: Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome that is caused by a novel coronavirus 2 (SARS-CoV-2). It originated in China late December 2019 and was declared a global pandemic on March 12, 2020. Most reports of COVID-19 cases either presented with neurological manifestations or complications involve adults. Only few cases were reported in pediatric patients.
Objective: To report COVID-19 pediatric cases with neurological manifestations and identify the wide spectrum of its manifestations.
Design setting and participants: This was a retrospective, observational case series. Data of pediatric patients infected by SARS-CoV-2 presenting with neurological manifestations at King Abdullah Specialized Children Hospital in King Abdulaziz Medical City in Riyadh were collected from May 23 to June 30, 2020.
Results: We encountered 5 COVID-19 cases with neurological manifestations. Three patients who were previously healthy had new-onset neurological symptoms. Symptoms and signs included encephalopathy, ataxia, headache, seizure, papilledema, ophthalmoplegia, hyporeflexia, and different clinical spectra, such as Miller Fisher syndrome, meningoencephalitis, and idiopathic intracranial hypertension. Other patients attending our center were incidentally found to be SARS-CoV-2-positive, which caused a delay in the investigations required to reach diagnosis.
Conclusions and relevance: Our cases highlight the wide clinical spectrum of neurological manifestations in COVID-19 patients. Given the paucity of information about pediatric COVID-19 cases with neurological symptoms, we here reported these cases to shed light on the association between SARS-CoV-2 and neurological presentation. Moreover, our study indicates that many investigations are being delayed and could affect diagnosis and treatment.
Keywords: CNS, central nervous system; COVID-19; COVID-19, coronavirus disease 2019; CSF, cerebrospinal fluid; CT, computed tomography; EEG, electroencephalogram; ER, emergency room; IVIG, intravenously administered immunoglobulin; MCA, middle cerebral artery; MRI, magnetic resonance imaging; NICU, neonatal intensive care unit; Neurological manifestation; Novel coronavirus; Pediatric COVID-19; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; WBC, white blood cell.
. 2021 Sep;24:100355.
doi: 10.1016/j.ensci.2021.100355. Epub 2021 Jul 9.
Pediatrics COVID-19 and neurological manifestations: Single tertiary centre experience
Lama Aljomah[SUP] 1 [/SUP], Sara Almedlej[SUP] 1 [/SUP], Duaa Baarmah[SUP] 1 2 [/SUP], Waleed Altwaijri[SUP] 1 2 [/SUP], Ahmad Alrumayyan[SUP] 1 2 [/SUP], Muhammad Talal Alrifai[SUP] 1 2 [/SUP], Mohammed Almuqbil[SUP] 1 2 3 [/SUP], Mohammad Alshalaan[SUP] 1 2 [/SUP]
Affiliations
- PMID: 34307923
- PMCID: PMC8268626
- DOI: 10.1016/j.ensci.2021.100355
Abstract
Importance: Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome that is caused by a novel coronavirus 2 (SARS-CoV-2). It originated in China late December 2019 and was declared a global pandemic on March 12, 2020. Most reports of COVID-19 cases either presented with neurological manifestations or complications involve adults. Only few cases were reported in pediatric patients.
Objective: To report COVID-19 pediatric cases with neurological manifestations and identify the wide spectrum of its manifestations.
Design setting and participants: This was a retrospective, observational case series. Data of pediatric patients infected by SARS-CoV-2 presenting with neurological manifestations at King Abdullah Specialized Children Hospital in King Abdulaziz Medical City in Riyadh were collected from May 23 to June 30, 2020.
Results: We encountered 5 COVID-19 cases with neurological manifestations. Three patients who were previously healthy had new-onset neurological symptoms. Symptoms and signs included encephalopathy, ataxia, headache, seizure, papilledema, ophthalmoplegia, hyporeflexia, and different clinical spectra, such as Miller Fisher syndrome, meningoencephalitis, and idiopathic intracranial hypertension. Other patients attending our center were incidentally found to be SARS-CoV-2-positive, which caused a delay in the investigations required to reach diagnosis.
Conclusions and relevance: Our cases highlight the wide clinical spectrum of neurological manifestations in COVID-19 patients. Given the paucity of information about pediatric COVID-19 cases with neurological symptoms, we here reported these cases to shed light on the association between SARS-CoV-2 and neurological presentation. Moreover, our study indicates that many investigations are being delayed and could affect diagnosis and treatment.
Keywords: CNS, central nervous system; COVID-19; COVID-19, coronavirus disease 2019; CSF, cerebrospinal fluid; CT, computed tomography; EEG, electroencephalogram; ER, emergency room; IVIG, intravenously administered immunoglobulin; MCA, middle cerebral artery; MRI, magnetic resonance imaging; NICU, neonatal intensive care unit; Neurological manifestation; Novel coronavirus; Pediatric COVID-19; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; WBC, white blood cell.