Extrapulmonary manifestations of COVID-19 in children: a comprehensive review and pathophysiological considerations

Aims: In response to the rapid spread of COVID-19, this paper provides health professionals with better accessibility to available evidence, summarising findings from a systematic overview of systematic reviews of the neurological symptoms seen in patients with COVID-19. Implications of so-called ‘Long Covid’ on neurological services and primary care and similarities with other neurological disorders are discussed. Methods: Firstly, a systematic overview of current reviews of neurological symptoms of COVID-19 was conducted. Secondly, the implications of these findings are discussed in relation to the potential effect on neurological services and the similarities in the experience of patients with COVID-19 and those with other neurological disorders. A total of 45 systematic reviews were identified within seven databases, published between 11 April 2020 and 15 October 2020, following a search in June 2020, updated on 20 October 2020. Results: The results indicated that COVID-19 exhibits two types of neurological symptoms; life-threatening symptoms such as Guillain–Barre Syndrome (GBS) and encephalitis, and less devastating symptoms such as fatigue and myalgia. Many of these so-called lesser symptoms appear to be emerging as longer-term for some sufferers and have been recently labelled Long Covid. When compared, these less devastating symptoms are very similar to other neurological conditions such as chronic fatigue syndrome (CFS) and functional neurological disorder (FND). Conclusion: Implications for neurological healthcare services in the United Kingdom (UK) may include longer waiting times and a need for more resources (including more qualified health professionals). There is also a possible change-effect on health professionals’ perceptions of other neurological conditions such as CFS and FND. Future research is recommended to explore changes in health professionals’ perceptions of neurological symptoms because of COVID-19.

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“…Finally, 45 systematic reviews met the inclusion criteria and were included in this overview. 11 – 55 …”

Section: Resultsmentioning

confidence: 99%

The neurological symptoms of COVID-19: a systematic overview of systematic reviews, comparison with other neurological conditions and implications for healthcare services

Wildwing

Holt

2021

Therapeutic Advances in Chronic Disease

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“…Cutaneous lesions of COVID-19 occur in more than 8% of hospitalized children 115 and are the 7 th most common extrapulmonary manifestation. 116 There are several case reports and case series of various cutaneous eruptions in COVID positive children. Children with COVID-19 and skin manifestations carry an overall better prognosis than those without.…”

Section: Pediatric Covid-19mentioning

confidence: 99%

Clinical Patterns and Morphology of COVID-19 Dermatology

Agnihothri

Fox

2021

Dermatologic Clinics

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Synopsis Coronavirus disease 2019 (COVID-19), an emergent disease caused by severe acute respiratory syndrome cornonavirus 2 (SARS-CoV-2), has rapidly spread throughout the globe since its discovery in December 2019. Although first appreciated to cause pneumonia, numerous organ systems are now known to be involved. The objective of this article is to review the broad spectrum of cutaneous manifestations reported in association with SARS-CoV-2 infection. The most commonly reported cutaneous manifestations associated with COVID-19 infection include pernio (chilblain)-like acral lesions, morbilliform (exanthematous) rash, urticaria, vesicular (varicella-like) eruptions, and vaso-occlusive lesions (livedo racemosa, retiform purpura). It is important to consider SARS-CoV-2 infection in the differential diagnosis of a patient presenting with these lesions in the appropriate clinical context, as cutaneous manifestations may be present in otherwise asymptomatic individuals, or present prior to developing other symptoms of infection. With increased access to diagnostic testing, we are beginning to understand the utility and limitations of currently available assays.

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“…Severe acute respiratory syndrome causing coronavirus (SARS‐CoV‐2) is a new coronavirus responsible for the pandemic named coronavirus disease 2019(COVID‐19). Although the pathogenesis of the disease has not been completely understood yet, it may cause clinical pictures with various degrees of multisystem involvement 1,2 …”

Section: Characteristics Of Patients % (N)mentioning

confidence: 99%

“…Studies have indicated that coronavirus can also cause cutaneous lesions; however, specific cutaneous symptoms of COVID‐19 infection have not been disclosed yet. The prevalence of cutaneous manifestations in COVID‐19 patients was between 0.2% and 20.4% in the recently published studies 1,3‐6 and 3.4% in a review including 28 studies where the patients aged between 0 and 18 years age had COVID‐19 2 . In this respect, we aimed to analyze the incidence and the types of cutaneous manifestations associated with COVID‐19 infections in pediatric patients.…”

Section: Characteristics Of Patients % (N)mentioning

confidence: 99%