Pediatric Neurology ( IF 3.8 ) Pub Date : 2022-07-06 , DOI: 10.1016/j.pediatrneurol.2022.06.010 Lokesh Saini 1 , Deepthi Krishna 1 , Sarbesh Tiwari 2 , Jagdish Prasad Goyal 1 , Prawin Kumar 1 , Daisy Khera 1 , Bharat Choudhary 1 , Siyaram Didel 1 , Ravisekhar Gadepalli 3 , Kuldeep Singh 1
Background
The neurological manifestation following a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is varied, and till now, only a few studies have reported the same.
Methods
We used retrospective data from May to July 2021 and prospective study data from August to September 2021, including that from children aged between one month and 18 years who presented to a tertiary care referral center with the neurological manifestation and had a history of coronavirus disease 2019 (COVID-19) infection or exposure and positive SARS-CoV-2 serology. The neuroradiological manifestations were further categorized as in a predesigned proforma.
Results
Case records of the 18 children who fulfilled the criteria were included in the study; among them, seven (38.8%) were male and 11 (61.1%) were female. Predominant presentation in our study group was status epilepticus (six of 18) and Guillain-Barré syndrome (five of 18). Other manifestations included stroke (two of 18), demyelinating syndromes (three of 18), and autoimmune encephalitis (two of 18). Most of the children had favorable outcomes except for one mortality in our cohort.
Conclusions
Delayed complications following SARS-CoV-2 infection are seen in children. A temporal correlation was noted between the COVID-19 infection and the increasing number of neurological cases after the second wave. Steroids could be beneficial while treating such patients, especially in the presence of high inflammatory markers. Testing for SARS-CoV-2 serology during the pandemic can give a clue to the underlying etiology. Further multicentric studies are required to understand the varied neurological manifestations following SARS-CoV-2 infection in children.
中文翻译:
儿童 COVID-19 后免疫介导的神经系统并发症:一项双面研究
背景
严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 感染后的神经系统表现多种多样,到目前为止,只有少数研究报告了相同的情况。
方法
我们使用了 2021 年 5 月至 2021 年 7 月的回顾性数据和 2021 年 8 月至 2021 年 9 月的前瞻性研究数据,包括来自 1 个月至 18 岁的儿童,这些儿童因神经系统表现就诊于三级医疗转诊中心,并有 2019 冠状病毒病史(COVID-19) 感染或暴露以及 SARS-CoV-2 血清学阳性。神经放射学表现进一步分类为预先设计的形式。
结果
符合标准的18名儿童的病例记录被纳入研究;其中男性7人(38.8%),女性11人(61.1%)。我们研究组的主要表现是癫痫持续状态(18 人中有 6 人)和格林-巴利综合征(18 人中有 5 人)。其他表现包括中风(18 人中有两人)、脱髓鞘综合征(18 人中有三人)和自身免疫性脑炎(18 人中有两人)。除了我们队列中的一个死亡率外,大多数儿童都有良好的结果。
结论
在儿童中可以看到 SARS-CoV-2 感染后的迟发并发症。注意到 COVID-19 感染与第二波之后神经系统病例数量增加之间存在时间相关性。在治疗此类患者时,类固醇可能是有益的,尤其是在存在高炎症标志物的情况下。在大流行期间检测 SARS-CoV-2 血清学可以为潜在的病因提供线索。需要进一步的多中心研究来了解儿童感染 SARS-CoV-2 后的各种神经系统表现。